检验医学与临床2016，Vol.13Issue(18)：2573-2575,3.DOI:10.3969/j.issn.1672-9455.2016.18.008
小潮气量通气在具有发生急性呼吸窘迫综合征高危因素患者中的应用研究
Study on application of low tidal volume ventilation in patients with risk factors of acute respiratory distress syndrome occurrence
摘要
Abstract
Objective To explore the clinical effect of low tidal volume ventilation used in the patients with high risk factors of acute respiratory distress syndrome (ARDS) .Methods Two hundreds patients with acute respiratory failure requiring invasive me‐chanical ventilation admitted to ICU of the intensive medicine and infection departments of our hospital from August 2014 to Sep‐tember 2016 were selected as research subjects ,by a single randomized method for conducting the mechanical ventilation they were divided into the study group and the control group ,100 cases in each group .The study group received low tidal volume 6 - 8 mL/kg ,end expiratory pressure 5 - 8 mm H2 O ,while the control group was given tidal volume 10 - 12 mL/kg after tracheal intubation , and the positive expiratory end pressure 0 - 5 mm H2 O according to the disease condition .The oxygen partial pressure(PaO2 ) ,par‐tial pressure of carbon dioxide(PaCO2 ) ,oxygenation index ,respiratory mechanical indicators ,inflammatory indicators ,mechanical ventilation indicators ,hospitalization time ,ARDS occurrence rate ,28 d mortality rate after ventilation were compared .Results The PaO2 and PaO2 / FiO2 improvement effect in the study group was more obvious than those in the control group (P< 0 .05) .The pH value and PaCO2 indicators after treatment had no statistically significant differences between the two groups(P> 0 .05) ;the lung compliance enhance was obvious ,the peak airway pressure and plateau pressure were significantly lower than those in the control group ,the difference was statistically significant (P< 0 .05) ;the IL6 level after treatment in the study group was significantly de‐creased compared with the control group ,the difference was statistically significant (P< 0 .05) ,the TNF‐α level in the study group was also significantly lower than that in the control group ,the difference was statistically significant (P< 0 .05) ;the hospitalization time ,incidence rate of ARDS and 28 d mortality rate in the study group were significantly lower than those in the control group ,the difference was statistically significant (P< 0 .05) .Conclusion The application of low tidal volume ventilation in the patients with high risk factors of ARDS has the efficacies for reducing the pulmonary injury ,decreasing the ARDS occurrence rate and mortality rate ,which is worthy of being widely applied in clinic .关键词
小潮气量通气/急性呼吸窘迫综合征/高危因素患者Key words
low tidal volume ventilation/acute respiratory distress syndrome/patients with risk factors引用本文复制引用
杨天星,叶碧华,李秀丹,刘星,黄明礼..小潮气量通气在具有发生急性呼吸窘迫综合征高危因素患者中的应用研究[J].检验医学与临床,2016,13(18):2573-2575,3.基金项目
四川省绵阳市卫生和计划生育委员会科研项目（201423）。 （）
