序贯通气治疗重症急性胰腺炎所致急性呼吸窘迫综合征的临床研究

目的探讨有创-无创序贯通气疗法在治疗重症胰腺炎所致急性呼吸窘迫综合征(ARDS)中的疗效。方法将78例重症胰腺炎所致ARDS患者随机分为有创通气组(A组,n=38)与序贯通气组(B组,n=40),对比分析两组有创通气时间、总机械通气时间、呼吸机相关肺炎(VAP)发生率和病死率等。结果 B组有创通气时间(3.45±1.24)d]较A组(4.27±2.53)d]明显缩短,差异有统计学意义(P<0.05);B组VAP发生率(5.00%)较A组(26.32%)明显降低,同时B组病死率(2.50%)较A组(10.53%)明显下降,差异有统计学意义(P<0.05);两组总机械通气时间差异无统计学意义(P>0.05)。结论有创-无创序贯通气疗法治疗重症胰腺炎所致急性呼吸窘迫综合征可有效缩短有创通气时间、降低VAP发生率及病死率,具有肯定的临床疗效。

The clinical value of sequential mechanical ventilation in patients with acute respiratory distress syndrome caused by severe acute pancreatitis

Objective To investigate the effect of invasive-noninvasive sequential mechanical ventilation on treating patients with acute respiratory distress syndrome caused by severe acute pancreatitis.Methods 78 cases of acute respiratory distress syndrome caused by severe acute pancreatitis were randomly divided into invasive ventilation group(group A,n=38) and sequential mechanical ventilation group(group B,n=40).The invasive ventilation duration,total mechanical ventilation duration,incidence and case-fatality rate of ventilator associated pneumonia(VAP) were measured and analyzed.Results Compared with group A,group B had significantly shorter invasive ventilation duration (4.27±2.53)d vs 3.45±1.24)d],lower rate of VAP(26.32% vs 5.00%) and case fatality(10.53% vs 2.50%)(P<0.05).There was no statistical difference in total mechanical ventilation duration between the two groups.Conclusion The invasive-noninvasive sequential mechanical ventilation is more effective in patients with acute respiratory distress syndrome caused by severe acute pancreatitis by shortening the time of invasive ventilation duration and decreasing the incidence and case fatality of VAP.