大连医科大学学报
大連醫科大學學報
대련의과대학학보
JOURNAL OF DALIAN MEDICAL UNIVERSITY
2014年
2期
140-143
,共4页
保守性液体管理策略%开放性液体管理策略%急性呼吸窘迫综合征( ARDS)%血管外肺水( EVLW)%预后
保守性液體管理策略%開放性液體管理策略%急性呼吸窘迫綜閤徵( ARDS)%血管外肺水( EVLW)%預後
보수성액체관리책략%개방성액체관리책략%급성호흡군박종합정( ARDS)%혈관외폐수( EVLW)%예후
conservative fluid management strategy%open liquid management strategy%acute respiratory distress syn-drome ( ARDS)%extravascular lung water ( EVLW)%prognosis
目的:探讨不同液体管理策略对急性呼吸窘迫综合征( ARDS )预后的影响。方法将2008年7月-2012年7月间入住大连大学附属中山医院的100例按1994年欧美联席会议所提出的诊断标准诊断,将ARDS患者随机分为保守性液体管理策略(CFMS)组与开放性液体管理策略(LFMS)组,各50例。对两组血管外肺水(EV-LW)、死亡例数、机械通气时间以及住ICU的时间、术后患者生活质量等进行比较。结果(1) CFMS组每日液体入量明显少于LFMS组(P<00.5),而液体出量明显大于LFMS组(P<0.05);CFMS组每日出入量之间的差值均小于LFMS组(P<0.05);CFMS组EVLW下降速度明显快于LFMS组(P<0.05)。(2)CFMS组与LFMS组病死率差异无显著性意义(P>0.05),但CFMS组机械通气时间、住ICU时间均明显小于LFMS组(P<0.05)。(3)根据QLQC-30生活质量评价标准,CFMS组各项得分均明显高于LFMS组(P<0.05)。结论保守性液体管理策略在一定程度上能更好地降低患者EVLW,提高患者生活质量。
目的:探討不同液體管理策略對急性呼吸窘迫綜閤徵( ARDS )預後的影響。方法將2008年7月-2012年7月間入住大連大學附屬中山醫院的100例按1994年歐美聯席會議所提齣的診斷標準診斷,將ARDS患者隨機分為保守性液體管理策略(CFMS)組與開放性液體管理策略(LFMS)組,各50例。對兩組血管外肺水(EV-LW)、死亡例數、機械通氣時間以及住ICU的時間、術後患者生活質量等進行比較。結果(1) CFMS組每日液體入量明顯少于LFMS組(P<00.5),而液體齣量明顯大于LFMS組(P<0.05);CFMS組每日齣入量之間的差值均小于LFMS組(P<0.05);CFMS組EVLW下降速度明顯快于LFMS組(P<0.05)。(2)CFMS組與LFMS組病死率差異無顯著性意義(P>0.05),但CFMS組機械通氣時間、住ICU時間均明顯小于LFMS組(P<0.05)。(3)根據QLQC-30生活質量評價標準,CFMS組各項得分均明顯高于LFMS組(P<0.05)。結論保守性液體管理策略在一定程度上能更好地降低患者EVLW,提高患者生活質量。
목적:탐토불동액체관리책략대급성호흡군박종합정( ARDS )예후적영향。방법장2008년7월-2012년7월간입주대련대학부속중산의원적100례안1994년구미련석회의소제출적진단표준진단,장ARDS환자수궤분위보수성액체관리책략(CFMS)조여개방성액체관리책략(LFMS)조,각50례。대량조혈관외폐수(EV-LW)、사망례수、궤계통기시간이급주ICU적시간、술후환자생활질량등진행비교。결과(1) CFMS조매일액체입량명현소우LFMS조(P<00.5),이액체출량명현대우LFMS조(P<0.05);CFMS조매일출입량지간적차치균소우LFMS조(P<0.05);CFMS조EVLW하강속도명현쾌우LFMS조(P<0.05)。(2)CFMS조여LFMS조병사솔차이무현저성의의(P>0.05),단CFMS조궤계통기시간、주ICU시간균명현소우LFMS조(P<0.05)。(3)근거QLQC-30생활질량평개표준,CFMS조각항득분균명현고우LFMS조(P<0.05)。결론보수성액체관리책략재일정정도상능경호지강저환자EVLW,제고환자생활질량。
Objective To study the effect of different fluid -management strategies on the patients with acute respiratory distress syndrome (ARDS).Methods The patients (100 cases) with ARDS in our hospital from July 2008 to July 2012 were randomly divided into two groups:group CFMS (50 cases) and group LFMS (50 cases).The EVLW,mortality rate, mechanical ventilation time , ICU time and postoperative patients quality of life between the two groups were compared .Re-sults (1) the volume of liquid intake of the group CFMS in 24 hours was less than the group LFMS (P<0.05), the vol-ume of liquid outtake of group CFMS in 24 hours was much more than the group LFMS (P<0.05).The dropping speed of EVLW in group CFMS was faster than the group LFMS LS (P<0.05).(2) The mortality rate between the two groups had no statistical difference (P>0.05), but mechanical ventilation time and ICU time of LFMS group were significantly less than CFMS group (P<0.05).(3) According to the QLQC-30 life quality evaluation standard, the quality indexes of the group LFMS were significantly higher than the CFMS group ( P<0 .05 ) .Conclusion The conservative fluid management strategy is much better to reduce lung water outside blood vessels and improves pulmonary function and life quality to some extent.