肺保护性通气策略治疗肺内和肺外源性急性呼吸窘迫综合征的临床对比-内科学(呼吸系病)专业论文.docxVIP

万方数据 万方数据 结论 本研究在积极处理原发病的同时给予 ARDS 患者应用肺保护性策略进行 治疗，能够改善患者的呼吸力学及气体交换，有助复张肺泡，改善肺功能，并进一 步提示肺保护性策略对于肺外源性急性呼吸窘迫综合征治疗的肺功能的改善在治 疗 30 分钟时优于肺内源急性呼吸窘迫综合征，但之后的 24 小时呼吸力学和血气指 标改善没明显差异。两者在使用呼吸机时间及住院时间上没有差异。 硕士研究生 袁庆杰 （内科学呼吸系病） 指导教师 李连弟 教授 关键词：肺保护性通气策略；机械通气；肺内急性呼吸窘迫综合征；肺 外源性急性呼吸窘迫综合征 Abstract Objective To take in the lungs and pulmonary lung protective ventilation strategy of exogenous acute respiratory distress syndrome in patients with respiratory mechanics, blood gas analysis, computer time and average hospitalization days of clinical difference comparative analysis. Methods Choose since January 1, 2012 to June 30, 2014 in our hospital intensive medicine, respiratory medicine, thoracic surgery hospital treatment of 86 patients with acute respiratory distress syndrome, and is based on the primary or secondary is divided into two groups: endogenous pulmonary acute respiratory distress syndrome group (group ARDSp) and pulmonary exogenous acute respiratory distress syndrome group (ARDSexp group). 49 cases of 86 cases of patients are men, the other 37 cases are women，Including ARDSp group of 40 cases of patients; Of severe pneumonia in 11 cases, pulmonary contusion； 29 cases of 46 patients with ARDSexp group, including 12 cases of severe infection, acute pancreatitis in 2 cases, 32 cases of multiple trauma. Two groups of patients in the general clinical data including age, gender composition ratio on the comparison of difference of no statistical significance (P 0.05). Lung protective ventilation strategy should be used in all patients treated, on two groups of patients with the breathing machine on respiratory mechanics, blood gas index, the average time and hospital stay comparative analysis. Results (1) 40 cases of patients in the ARDSp group and 46 cases in group ARDSexp were treated 0 minutes to start the Ppeak, Pplat, Pmean value of the difference was not statistically significant ；(2) 40 cases of ARDSp patients in the treatment group after 30 minutes, 1 hours, 3 hours, 12