液体负平衡对腹部损伤并ARDS肺功能保护的临床研究

目的 探讨液体负平衡对腹部损伤并急性呼吸窘迫综合征(ARDS患者肺功能的保护作用及其可能机制.方法 将130例ARDS 患者分为液体负平衡组(观察组)和对照组,每组65例.对照组患者采用常规机械通气、抗感染治疗,观察组患者 在对照组的基础上,采取一定的措施保持液体负平衡.观察并记录两组患者血流动力学指标、肺部炎症因子水平及呼吸机机械通 气情况.结果 治疗后两组患者心脏指数(CI) 、心排出量(CO)值正常,心功能未受到影响,观察组患者血管外肺水含量指数 (EVLWI)值下降更明显,肺水肿症状改善明显;两组患者肺部炎症均得到控制,肺功能均有所改善,但观察组患者效果更显著;与 对照组比较,观察组患者平均通气时间更短,两组比较差异有统计学意义(P＜ 0.05) .结论 腹部损伤并ARDS 治疗中,保持患 者液体负平衡,对患者肺部功能保护较好,值得临床推广与使用.

Clinical study on protective effect of negative fluid balance on pulmonary function in abdominal trauma and ARDS

Objective To investigate the protective effecof the negative fluid balance on the lung function in abdominal trau-mand acute respiratory distressyndrome (ARDS) and itpossible mechanism .MethodTotally 130 ARDpatientwere ran-domly divided into the negative fluid balance group (observation group ,65 cases) and the control group (65 cases) .The control group watreated with therapy of the conventional mechanical ventilation and anti-infection ,while on thibasithe observation group adopted certain measure fomaintaining the negative fluid balance .The hemodynamiindexe,pulmonary inflammatory factoleveland mechanical ventilation conditionwere observed and recorded in the two group.ResultThe cardiaindex (CI) and car-diaoutpu(CO) value aftetreatmenin the two groupwere normal and the hearfunction wanoaffected ,the decrease of the extravasculalung wateindex (EVLWI) in the observation group wamore obviouand the improvemenof pulmonary edemsymptomwamore significan;the pulmonary inflammation in the two groupwacontrolled ,and the pulmonary function waim-proved to some exten,buthe effecin the observation group wamore significan;the average ventilation time in the observation group washorte,which could significantly reduce the ventilatosupporintensity ,the differencebetween the two groupwere statistically significant(P＜0 .05) .Conclusion Maintaining the negative fluid balance in the treatmenof abdominal traumcompli-cating ARDhathe betteeffecfoprotecting the pulmonary function and iworthy of being clinically promoted and applied .