早期ARDS患者无创通气时肺复张的临床疗效

目的探讨对早期急性呼吸窘迫综合征(ARDS)患者应用无创通气时(NIV)进行肺复张(RM)的临床疗效。方法 35例ARDS早期患者,随机分为治疗组和对照组,对照组常规进行NIV,治疗组在常规NIV的基础上,应用吸气气道正压(IPAP)、呼气气道正压(EPAP)各20cmH_2O,保持120秒的方法进行肺复张(RM)治疗,每4～6小时一次,72小时后观察两组患者氧合指数(PaO_2/FiO_2)、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、心率(HR)、血压(BP)、平均动脉压(MAP)、中心静脉压(CVP)等指标的差别。结果与对照组比较,治疗组PaO_2/FiO_2、PaO_2明显升高,差异具有显著统计学意义(P<0.05),PaCO_2、HR、BP、MAP、CVP等指标的差异无统计学意义(P>0.05)。结论对早期ARDS患者在NIV时进行RM,可以改善患者氧合,对循环动力学没有明显影响。

Clinical Efficacy of Recruitment Maneuvers in the Early Stage of Acute Respiratory Distress Syndrome Treated by Noninvasive Ventilation

Objective To investigate the clinical efficacy of recruitment maneuvers(RM) in the early stage of acute respiratory distress syndrome(ARDS) treated by noninvasive ventilation(NIV).Methods 35 patients in the early stage of ARDS were divided into two groups randomly:therapy group and control group.The control group was given NIV routinely,The therapy group was treated by NIV while given the RM every 4 ～ 6 hours by maintaining inspiratory positive airway pressure(IPAP) at 20 cmH_2O and expiratory positive airw...