应用保护性机械通气救治烧伤复合肺爆震伤

目的探讨早期气管切开保护性机械通气在重度烧伤复合肺爆震伤救治中的重要性。方法对30例重度烧伤复合肺爆震伤患者早期气管切开并采用低潮气量、低呼气末正压通气（PEEP）和“允许性高碳酸血症”的保护性机械通气模式。分别在机械通气前和通气后1h、1d、3d、5d行动脉血气分析，并测定心率、中心静脉压变化，以及胸部X线检查。结果本组早期气管切开机械通气后，其氧合指征氧分压（PaO2）和动脉血氧饱和度（SPO2）明显改善，在“允许性高碳酸血症”状态下，患者心率、中心静脉压变化不明显。治疗期间，未见呼吸机相关性肺损伤发生。结论对重度烧伤复合肺爆震伤患者采用早期气管切开保护性机械通气治疗效果理想，并可有效预防呼吸机相关性肺损伤的发生。

Application of protective ventilation in the treatment of the burned patients with burst injury of the lungs

Objective To explore the importance of bronchectomy and protective ventilation in the treatment of the severe burns with burst injury of the lungs.Methods 30 patients with severe burns and blast injury of the lungs were treated with the protective ventilation including low tidal volume,low positive end expiratory pressure and permissive hypercapnia.The changes of blood gas,heart rate,central venous pressure and chest X ray were detected before and 1h,1d,3d,5d after ventilation.Results The oxygenation(PaO2,S...