中国医学创新Issue(5)：10-13,14,5.DOI:10.3969/j.issn.1674-4985.2016.05.003
小潮气量联合肺复张在重症肺炎肺损伤患儿中的应用
The Application of Low Tidal Volume Combined with Lung Recruitment Maneuver in the Treatment of Acute Lung Injury Resulted from Infantile Severe Pneumonia
摘要
Abstract
Objective:To observe the effectiveness and safety of low tidal volume combined with lung recruitment maneuver(RM) in the treatment of infantile severe pneumonia complicated by acute lung injury (ALI).Method:42 children with infantile severe pneumonia complicated by ALI who received mechanical ventilation in the PICU of our hospital from May 2013 to July 2015 were selected as the research objects,and they were randomly divided into the experimental group and the control group,21 cases in each group.The experimental group was given low tidal volume(VT:6-8 mL/kg) respiratory support and RM within 24 hours after admission. The control group was given mechanical ventilation(VT:8-10 mL/kg) and not for RM in the treatment.The hemodynamic parameters,respiratory mechanics,blood gas changes,mechanical ventilation time,oxygen inhalation time,hospitalization time,the success rate of discontinuance of mechanical and complication rate between the two groups before and after ventilation were compared and analyzed.Result:Lung recruitment maneuver was performed for 73 times in 21 children of the experimental group on the basis of low tidal volume,PIP,R, PEEP,FiO2,Paw after RM for 5,15,60 min were all significantly lower than before RM(P<0.05),VT,SpO2 were elevated after RM 5,5,60 min(P<0.05).R、MAP before and after RM were stable(P>0.05).Compared with before ventilation,the blood gas analysis of the two groups after ventilation were improved(P<0.05).The difference were statistically significant in the PaO2/FiO2,Cdyn,Wobv between the two groups after mechanical ventilation(P<0.05).The mechanical ventilation time,oxygen inhalation time and hospitalization time of the experimental group were significantly shorter than the control group,the complications rate of the experimental group was significantly lower than the control group,the differences were statistically significant(P<0.05). Conclusion:Low tidal volume combined with RM in the treatment of infantile severe pneumonia complicated by ALI is safe and effective,is worthy of clinical promotion.关键词
重症肺炎/肺损伤/肺复张/潮气量/儿童Key words
Severe pneumonia/Lung injury/Lung recruitment maneuver/Tidal volume/Child引用本文复制引用
沈彤,刘成军,刘茂花,沈红,李海英,李兴莉..小潮气量联合肺复张在重症肺炎肺损伤患儿中的应用[J].中国医学创新,2016,(5):10-13,14,5.基金项目
山东省临沂市2015年医疗卫生科技发展计划科研立项项目 （）
