限制性液体管理联合保护性机械通气策略治疗急性肺损伤

目的 探讨限制性液体管理联合肺保护性机械通气策略在急性肺损伤治疗中的作用.方法 将40例确诊为急性肺损伤患者随机分为观察组（22例）及对照组（18例）,在保护性机械通气基础上,对观察组实施限制性液体管理的治疗策略,对照组则采取非限制性液体管理的治疗策略,比较两组患者在持续机械通气时间、重症监护室住院时间及肺外并发症（包括心、肾、肝功能衰竭）发生率方面的差别.结果 观察组持续机械通气时间及重症监护室住院时间明显比对照组缩短（P＜0.05）;两组肺外并发症发生率相似.结论 限制性液体管理联合肺保护性机械通气策略可缩短急性肺损伤患者持续机械通气及重症监护室住院时间,且不增加该类患者肺外并发症的发生率,是急性肺损伤有效、安全的治疗方法.

Treating acute lung injury by strategy of conservative fluid management combining with lung-protective ventilation

Objective To explore the role of strategy of conservative fluid management combining with lung-protective ventilation in treating acute lung injury. Methods 40 cases with final diagnosis of acute lung injury were selected and randomly divided into experimental group(22cases) and control group(18cases). Between two groups,on the basis of lung-protective ventilation,therapy policy of conservative fluid management was carried out in experimental group, and strategy with a liberal fluid management was taken in the other group. Hie duration of mechanical ventilation and intensive care together with the incidence rate of nonpulmonary complications( congestive heart failure,renal failure and liver failure) were compared between both groups. Results When compared with the control group,the experimental group had the shorter duration of mechanical ventilation and intensive care( P < 0.05 ). And the incidence rate of nonpulmonary complications were similar in both groups. Conclusion Strategy of conservative fluid management combining with lung-protective ventilation could shortened the duration of mechanical ventilation and intensive care for patients with acute lung injury without increasing the incidence rate of nonpulmonary complications, which was an effective and safe treatment and deserved consulting in clinical work.