早期不同呼吸支持模式对有机磷中毒合并呼吸衰竭病人心肺功能和炎症因子水平的影响

摘要：目的: 探讨早期不同呼吸支持模式对有机磷中毒合并呼吸衰竭（ARF）患者心肺功能和炎症因子水平的影响。方法：连续收集2016年1月至2019年12月在本院接受治疗的42例有机磷中毒合并ARF患者的临床资料，按照随机编号法分为A组和B组，每组21例，A组给予适应性支持通气呼吸支持模式（ASV），B组给予压力支持通气（PSV）+同步间歇指令性通气（SIMV）呼吸支持模式，比较两组患者治疗前后的心、肺功能指标、炎性因子水平、动脉血气指标。结果：两组患者治疗前的肺功能指标无明显差异（P>0.05），治疗后均明显改善，且A组患者的肺功能指标改善情况明显优于B组（P<0.05）；治疗前两组患者的心功能指标无明显差异（P>0.05），治疗后A组的PASP、RVd水平显著低于B组，EFRV水平高于B组，两组差异比较具有统计学意义（P<0.05）；两组患者治疗前炎性因子水平无明显差异（P>0.05），治疗后PCT、hs-CRP、IL-6水平均降低，A组变化较B组显著（P<0.05）；两组患者治疗前血气指标无明显差异(P>0.05)，治疗后A组的PaO2水平显著高于B组，PaCO2水平显著低于B组，两组比较差异具有统计学意义（P<0.05）。结论：ASV通气模式有利于有机磷中毒合并ARF患者的心、肺功能的恢复，降低患者的炎性因子水平，有助于患者自主呼吸能力的尽快恢复。

Effect of different early respiratory support modes on cardiopulmonary function and inflammatory factors in patients with organophosphorus poisoning and respiratory failure

Abstract: Objective: To explore the effect of different early respiratory support modes on cardiopulmonary function and inflammatory factors in patients with organophosphate poisoning and respiratory failure (ARF). Methods: The clinical data of 42 patients with organophosphorus poisoning and ARF who were treated in the hospital between January 2016 and December 2019 were collected. The patients were divided into group A and group B by the random numbering method, 21 cases in each group. Group A were given adaptive support ventilation (ASV), and group B were given pressure support ventilation (PSV) combined with synchronized intermittent mandatory ventilation (SIMV). The cardiopulmonary function indexes, inflammatory factors and arterial blood gas indexes were compared between the two groups before and after treatment. Results: There were no significant differences in lung function indexes between the two groups before treatment (P>0.05). After treatment, the lung function indexes were improved significantly, and the improvement was better in group A than group B (P<0.05). There were no significant differences in cardiac function indexes between the two groups before treatment (P>0.05). After treatment, PASP and RVd levels in group A were significantly lower than those in group B, and EFRV levels were higher than group B (P<0.05). There were no significant differences in levels of inflammatory factors between the two groups before treatment (P>0.05). After treatment, PCT, hs-CRP and IL-6 levels were decreased, and the changes in group A were more significant than those in group B (P<0.05). There were no significant differences in blood gas indexes between the two groups before treatment (P>0.05). After treatment, PaO2 in group A was significantly higher than that in group B, and PaCO2 was significantly lower than group B (P<0.05). Conclusion: ASV is conducive to the recovery of heart and lung function in patients with organophosphorus poisoning and ARF, and reduces the levels of inflammatory factors. It can also help quick recovery of spontaneous breathing.