小潮气量联合肺复张的策略在重症肺炎肺损伤治疗中的应用分析.docVIP

小潮气量联合肺复张的策略在重症肺炎肺损伤治疗中的应用分析 　　[摘要] 目的 探讨小潮气量与肺复张策略（RM）联合治疗重症肺炎肺损伤的临床疗效。方法 整群选择2013年3月―2014年6月该院儿科重症监护病房救治的重症肺炎肺损伤患儿76例，按随机数字表法分为观察组和对照组各38例。观察组采取小潮气量机械通气联合肺复张策略治疗，对照组单纯进行机械通气治疗，观察比较两组通气前后的血流动力学、血气分析指标变化，并对比两组并发症发生情况。结果 机械通气后，观察组氧合指数明显高于对照组，差异有统计学意义（P0.05）；观察组并发症发生率2.63%明显低于对照组15.79%，差异有统计学意义（P0.05）。 结论 小潮气量与肺复张策略联合治疗重症肺炎肺损伤疗效确切，且具有较高的安全性，值得临床推广。 　　[关键词] 肺复张策略；小潮气量；重症肺炎 　　[中图分类号] R725 [文献标识码] A [文章编号] 1674-0742（2016）07（c）-0098-03 　　[Abstract] Objective To investigate the low tidal volume and pulmonary rehabilitation Zhang Celve （RM） combined treatment of severe pneumonia clinical lung injury. Methods Group select March 2013 to June 2014 in our hospital in children pediatric intensive care unit for treatment of severe pneumonia in 76 cases of lung injury.According to the random number table method is divided into observation group and control group， each of 38 cases. The observation group adopted recruitment strategy for the treatment of mechanical ventilation with low tidal volume combined with lung，and the control group were treated with mechanical ventilation. The changes of hemodynamics and blood gas analysis indexes were observed and compared before and after ventilation in two groups， and the incidence of complications was compared between the two groups. Results After mechanical ventilation， the oxygenation index of the observation group was significantly higher than that of the control group， the difference was statistically significant （P 0.05）； The complication rate of observation group 2.63% was significantly lower than that of control group （15.79%）， the difference was statistically significant （P 0.05）. Conclusion Low tidal volume and lung recruitment strategy combination therapy has a definite therapeutic effect on severe pneumonia lung injury and has higher security， is worth the clinical promotion. 　　[Key words] Lung Zhang Celve； Tidal volume； Severe pneumonia 　　小儿重症肺炎是临床儿科常见病，具有病情发展快、危险程度高的特点[1]。目前临床针对重症肺炎肺损伤多采取小潮气量、最佳呼吸末压力（PEEP）等方式治疗，虽然能降低病