保护性机械通气在小儿脓毒症合并急性呼吸窘迫综合征的应用.docVIP

保护性机械通气在小儿脓毒症合并急性呼吸窘迫综合征的应用 　　[摘要] 目的 探讨保护性机械通气在小儿脓毒症合并急性呼吸窘迫综合征的应用。 方法 对我院42例小儿脓毒症合并急性呼吸窘迫综合征患儿进行保护性机械通气，定为观察组，取以往42例同种疾病采取传统机械通气方法的患儿的临床资料作为对照组，比较两种方法的应用效果。 结果 观察组患儿PaO2、PEEP数值高于对照组；病死率为4.76%，低于对照组的30.95%；PaCO2数值、24小时和撤机后的降钙素原水平和C反应蛋白水平也低于对照组，差异有统计学意义（P0.05）。 结论 对小儿脓毒症合并急性呼吸窘迫综合征患儿进行保护性机械通气可以降低降钙素原水平、C反应蛋白水平和死亡率，利于抑制炎症反应。 　　[关键词] 保护性机械通气；小儿脓毒症；急性呼吸窘迫综合征；应用效果 　　[中图分类号] R720.5 [文献标识码] A [文章编号] 2095-0616（2017）08-70-03 　　[Abstract] Objective To explore protective mechanical ventilation in application of pediatric sepsis complicated with acute respiratory distress syndrome. Methods 42 children with pediatric sepsis complicated with acute respiratory distress syndrome were given protective mechanical ventilation and they were set as the observation group.Clinical data of 42 children with the same disease receiving traditional mechanical ventilation were set as the control group.Application effect of two methods were compared. Results PaO2 and positive end expiratory pressure（PEEP） of children in the observation group were higher than those in the control group.The mortality of the observation group was 4.76%，lower than that of the control group 30.95%.In addition，PaCO2 values，calcitonin levels of 24 hours and after ventilator weaning and C-reactive protein level of the observation group were also lower than those of the control group.Differences were statistically significant（P0.05）. Conclusion Protective mechanical ventilation in application of pediatric sepsis complicated with acute respiratory distress syndrome can reduce calcitonin level，C-reactive protein level of and the mortality rate，which is helpful to inhibit the inflammatory response. 　　[Key words] Protective mechanical ventilation；Pediatric sepsis；Acute respiratory distress syndrome；Application effect 　　?毒症属于一种炎症反应，如得不到有效的控制将引发多种并发症，其中包括急性呼吸窘迫综合征，小儿患该病后极易引发死亡现象[1]。在小儿脓毒症合并急性呼吸窘迫综合征的治疗过程中，保护性机械通气的应用具有重要意义。本次研究选取我院2015年1月～2016年1月收治的84例患儿，通过对照分析方式，探讨保护性机械通气与传统机械通气应用于小儿脓毒症合并急性呼吸窘迫综合征治疗中的效果差异，现报道如下。 　　1 资