肌松剂在有创机械通气治疗淡水近乎淹溺致急性呼吸窘迫综合征中的运用

目的:探讨目前具有争议的肌松剂(维库溴铵)在有创机械通气治疗淡水近乎淹溺致急性呼吸窘迫综合征(ARDS)中的价值和运用时机.方法:分析我院2001年至今收治的31例淡水近乎淹溺敛ARDS患者,使用肌松剂存活患者作为治疗组,未使用肌松剂患者作为对照组,比较两组患者的血气分析及相关并发症、住院时间、住院费用.结果:治疗组24 h血气分析优于对照组,相关并发症及住院时间、住院费用无明显增加.结论:淹溺患者临床上常出现ARDS,给予足量镇静与镇痛药物治疗,仍达不到治疗目标,可考虑使用肌松剂;时间选择上宜早不宜晚,防止多器官功能不全综合征(MODS)的发生.

Utilization of muscle relaxant in mechanical ventilation for treating acute respiratory distress syndrome induced by water drowning

Objective：To investigate the clinical usage and the application opportunity of vecuronium bromide,a controversial muscle relaxing agent,in drown-induced acute respiratory distress syndrome （ARDS）.Methods：Thirty-one patients with drowning-induced ARDS admitted in our hospital since 2001 were enrolled in this study.The survival patients receiving muscle relaxant were taken as the treatment group,meanwhile,the patients without using muscle relaxing agent were classified as the control group.Blood-gas analysis,related complications,hospitalization duration,and medical expense during the period of hospitalization were compared between the two groups.Results：The patients in the treatment group exhibited better blood-gas results than the control group,without significant differences in related complications,hospitalization duration and medical expense.Conclusion：ARDS is a complication associated with drowning.When sufficient dose of sedative and analgesics failed to control the ARDS progression,the addition of muscle relaxant is reasonable,and it is prudent to prescribe this class of agents earlier in order to prevent the occurrence of multiple organ dysfunction syndrome（MODS）.