不同肺复张方法在ARDS治疗中的应用研究

目的:探讨三种不同的肺复张方法(RM)应用于治疗急性呼吸窘迫综合征(ARDS)患者的效果。方法:将63例ARDS患者随机分为A、B、C三组,每组21例,分别应用控制性肺膨胀、呼吸末正压递增法、压力控制法三种肺复张方法治疗,观察记录RM治疗前后患者氧和指数(PO2)、心率(HR)、中心静脉压(CVP)、平均动脉压(MAP)、动脉血氧分压(PaO2)、血氧饱和度(SpO2)指标的变化,并统计分析。结果:C组患者PaO2、PO2、SpO2水平在5min、10min显著高于其它两组(P<0.05);RM后三组患者短时间内心率均增快,CVP下降,MAP上升,A组变化幅度最大(P<0.05),25min后三组数据之间无显著差异(P>0.05)。结论:三种方法综合比较发现,压力控制法应用于ARDS患者的治疗更具有优势。

Effects comparison of three recruitment maneuvers for acute respiratory distress syndrome

Objective: To compare effects of three recruitment maneuvers(RM) for acute respiratory distress syndrome(ARDS).Methods:A total of 63 ARDS patients were randomly divided into group A(21 cases),group B(21 cases) and group C(21 cases),which were treated by three RM including sustained inflation(SI),increase progressively PEEP(IP) and pressure control ventilation(PCV),respectively.Heart rate,mean arterial blood pressure(MAP),central venous pressure(CVP) were recorded before and after RM and analyzed.Results:Level of PaO2、PO2 and SpO2 of group C were significant higher than that of the other two groups(P<0.05).After RM,MAP and heart rate were increased in short time,but CVP was decreased,changes of group A were more obviously than the other two groups(P<0.05).However,25 min later,the CVP and MAP of three groups were similar(P>0.05).Conclusion: PCV method shows advantages over the other two methods in ARDS treatment.