液体负平衡对腹部外伤伴ARDS患者血流动力学指标、炎症因子浓度的影响

目的 探讨液体负平衡对腹部外伤伴急性呼吸窘迫综合征(ARDS)患者血流动力学指标、炎症因子浓度的影响.方法 82例腹部外伤伴ARDS患者,采用电脑随机分组法分成对照组及观察组,各41例.对照组采用常规治疗,观察组在常规治疗的基础上采用液体负平衡治疗.比较两组患者的血流动力学指标心排血量(CO)、心脏指数(CI)、血管...

Effect of negative fluid balance on hemodynamic indexes and inflammatory factor concentration in patients with abdominal trauma and ARDS

Objective To discuss the effect of negative fluid balance on hemodynamic indexes and inflammatory factor concentration in patients with abdominal trauma and acute respiratory distress syndrome(ARDS).Methods A total of 82 patients with abdominal trauma and ARDS were divided into control group and observation group according to computer random grouping,with 41 cases in each group.The control group received conventional therapy,and the observation group received negative fluid balance based on the conventional therapy.The hemodynamic indexescardiac output(CO),cardiac index(CI),extravascular lung water index(EVLWI)],inflammatory factorinterleukin-6(IL-6)]concentration,oxygenation situation{partial pressure of oxygen(PaO2),alveolar-arterial oxygen partial pressure differenceP(A-a)O2]},mechanical ventilation conditionsfraction of inhaled oxygen(FiO2),plateau pressure(Pplat),positive end expiratory pressure(PEEP)],ventilator use time were compared between the two groups.Results After treatment,CO(4.07±0.68)L/min and CI(4.78±0.42)L/(min·m^2)of the observation group had no statistically significant difference compared with(3.98±0.65)L/min and(4.75±0.43)L/(min·m^2)of the control group(P>0.05).After treatment,EVLWI(5.37±0.29)ml/kg of the observation group was lower than(6.91±0.36)ml/kg of the control group,and the difference was statistically significant(P<0.05).After treatment,PaO2(102.74±5.85)mm Hg(1 mm Hg=0.133 kPa)of the observation group was higher than(87.57±5.36)mm Hg of the control group,and P(A-a)O2(7.35±3.51)mm Hg and IL-6(147.05±10.62)pg/ml were lower than(15.24±3.68)mm Hg and(194.83±12.59)pg/ml of the control group,and the difference was statistically significant(P<0.05).When offline,the PEEP(5.08±0.47)mm Hg,FiO2(40.28±1.69)%,and Pplat(11.24±1.48)mm Hg of the observation group were lower than(8.97±1.83)mm Hg and(50.83±1.27)%,(17.93±1.95)mm Hg of the control group,and the difference was statistically significant(P<0.05).The ventilator use time of the observation group was(4.62±0.37)d,which was shorter than(6.29±0.68)d of the control group,and the difference was statistically significant(P<0.05).Conclusion Maintaining negative fluid balance in the treatment of abdominal trauma with ARDS can effectively reduce the symptoms of pulmonary edema,improve lung infection and oxygenation,protect lung function,reduce the strength of ventilator support,and shorten the ventilator use time.It is worthy of promotion.