保护性肺通气治疗重症胸部创伤并ARDS的疗效观察.docVIP

保护性肺通气治疗重症胸部创伤并ARDS的疗效观察摘要：目的 探究保护性肺通气治疗对重症胸部创伤并呼吸窘迫综合征（ARDS ）的临床疗效。方法 选取我院60例重症胸部创伤合并ARDS患者为研究对象，按照治疗方法的不同分为观察组和对照组，两组患者均在BiPAP（Drager Savina）呼吸机辅助呼吸治疗的基础上进行治疗，观察组给予保护性肺通气治疗，对照组给予常规通气治疗；观察记录通气治疗24h后动脉血气分析PaO2、PaCO2和氧合指数（PaO2/ FiO2）并进行组间比较。结果 两组患者在治疗中共发生死亡8例，其中观察组1例，对照组7例。治疗24h后PaO2比较t=6.4386；PaCO2比较t=8.0692；PaO2/ FiO2比较t=5.2443；时间比较t=5.1803；总有效率比较χ2=12.4375；P均0.05，差异具有统计学意义。结论 保护性通气对重症肺部创伤合并ARDS的治疗具有操作简便、降低肺部机械性损伤、有效提高患者氧合功能以及治愈率，是一种安全有效的治疗方式。关键词：重症胸部创伤；呼吸窘迫综合症（ARDS）；保护性通气治疗；疗效Abstract：Objective To explore the protective lung ventilation treatment of severe chest trauma and the clinical efficacy of respiratory distress syndrome （ARDS）. Methods Select 60 patients with severe chest trauma with ARDS patients as the research object， according to the treatment method is divided into observation group and control group， two groups of patients were in BiPAP （Drager Savina） breathing machine auxiliary breath therapy treatment， on the basis of the observation group was given protective lung ventilation treatment， control group given conventional ventilation treatment； Arterial blood gas analysis after 24 h of treatment observation records ventilation PaO2， PaCO2 and oxygenation index （PaO2 / FiO2） and compared between groups. Results Two groups of patients in the treatment of the Chinese communist party in 8 cases died， the observation group 1 cases， control group in 7 cases. 24 h after treatment PaO2 compared t = 6.4386； PaCO2 compared t = 8.0692； PaO2 / FiO2 compared t = 5.2443； Time is t = 5.1803； Total effective rate is χ2=12.4375； P 0.05， the difference is statistically significant. Conclusion The treatment of lung trauma combined with severe ARDS protective ventilation has simple operation， to reduce the mechanical injury， improve the oxygenation in patients with lung function and the cure rate， is a kind of safe and effective treatment.Key words：Severe chest trauma； Respiratory distress syndrome （ARDS）； Protective ventilation treatment； Curative effect重症胸部创伤合并呼吸窘迫综合