控制性肺膨胀联合肺保护性通气策略在急性呼吸窘迫综合征的临床应用研究

耿平, 夏仲芳, 徐敏, 谈定玉, 吉孝祥, 徐继扬

耿平, 夏仲芳, 徐敏, 谈定玉, 吉孝祥, 徐继扬. 控制性肺膨胀联合肺保护性通气策略在急性呼吸窘迫综合征的临床应用研究[J]. 实用临床医药杂志, 2007, (9): 55-58,64. DOI: 10.3969/j.issn.1672-2353.2007.09.015
引用本文: 耿平, 夏仲芳, 徐敏, 谈定玉, 吉孝祥, 徐继扬. 控制性肺膨胀联合肺保护性通气策略在急性呼吸窘迫综合征的临床应用研究[J]. 实用临床医药杂志, 2007, (9): 55-58,64. DOI: 10.3969/j.issn.1672-2353.2007.09.015
Clinical Application of Sustained Inflation Combined with Lung Protective Ventilation Strategy in Patients with Acute Respiratory Distress Syndrome[J]. Journal of Clinical Medicine in Practice, 2007, (9): 55-58,64. DOI: 10.3969/j.issn.1672-2353.2007.09.015
Citation: Clinical Application of Sustained Inflation Combined with Lung Protective Ventilation Strategy in Patients with Acute Respiratory Distress Syndrome[J]. Journal of Clinical Medicine in Practice, 2007, (9): 55-58,64. DOI: 10.3969/j.issn.1672-2353.2007.09.015

控制性肺膨胀联合肺保护性通气策略在急性呼吸窘迫综合征的临床应用研究

详细信息
  • 中图分类号: R563.8

Clinical Application of Sustained Inflation Combined with Lung Protective Ventilation Strategy in Patients with Acute Respiratory Distress Syndrome

  • 摘要: 目的 观察控制性肺膨胀(SI)联合肺保护性通气策略对急性呼吸窘迫综合征(ARDS)患者的临床疗效.方法 以25例ARDS 病程早期的患者为研究对象,依据肺保护性通气策略确定基础通气模式,分别测定SI前、SI时, SI后10 min、1 h、2 h、3 h、4 h、5 h的肺气体交换、肺力学、血液动力学的变化.结果 25例中,有2例因血压明显下降而退出, 18例在实施SI后SaO2均有明显上升,有效率78.3%.SI时SaO2均有明显下降,但此后迅速上升, 10 min~1 h时达到最高值,疗效可维持4 h;SI能显著改善肺顺应性(Cdyn), SI后1 h时平台压(Pplat)即有明显下降,气道峰压(PIP), 平均气道压(Pmean)在4h时下降明显;SI时CVP明显增加,但在SI结束后很快恢复到SI前水平.25例中未有气压伤的表现.结论 SI联合肺保护性通气策略能有效复张塌陷的肺泡,降低气道压力,改善肺顺应性,增加氧合,对循环系统影响小,安全有效,但具有时效性,对于原发于肺部病变所致的ARDS合并血液动力学不稳定者应用SI要慎重.
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出版历程
  • 发布日期:  2008-01-23

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