医学综述
醫學綜述
의학종술
MEDICAL RECAPITULATE
2015年
7期
1324-1325
,共2页
急性呼吸窘迫综合征%机械通气%液体管理%抗炎%营养支持
急性呼吸窘迫綜閤徵%機械通氣%液體管理%抗炎%營養支持
급성호흡군박종합정%궤계통기%액체관리%항염%영양지지
Acute respiratory distress syndrome%Mechanical ventilation%Fluid management%Anti-inflammatory%Nutritional support
目的:探讨呼吸支持、液体管理、抗炎和抗凝等综合方法治疗急性呼吸窘迫综合征( ARDS)的疗效。方法对2006年1月至2012年12月四川省第四人民医院呼吸内科收治的ARDS患者52例,在积极处理原发病基础上,应用呼吸支持、液体管理、抗炎和抗凝等综合治疗措施,观察治疗前后相关临床指标的变化。结果52例ARDS患者死亡12例,病死率为23.1%;治疗48 h后,患者血氧饱和度、pH值、动脉血氧分压、碳酸氢根显著高于治疗前[(0.89±0.13)比(0.80±0.30)、(7.9±0.7)比(7.1±0.6)、(82.4±6.9) mmHg(1 mmHg=0.133 kPa)比(62.3±7.9) mmHg、(21.2±2.5) mmHg比(19.7±3.9) mmHg],二氧化碳分压显著低于治疗前[(40.6±6.9) mmHg 比(46.3± 8.4) mmHg,P<0.01]。结论经机械通气、液体管理、抗炎和抗凝等综合措施治疗 ARDS患者效果较好,治疗前后各项指标均有好转迹象,可有效降低其病死率。
目的:探討呼吸支持、液體管理、抗炎和抗凝等綜閤方法治療急性呼吸窘迫綜閤徵( ARDS)的療效。方法對2006年1月至2012年12月四川省第四人民醫院呼吸內科收治的ARDS患者52例,在積極處理原髮病基礎上,應用呼吸支持、液體管理、抗炎和抗凝等綜閤治療措施,觀察治療前後相關臨床指標的變化。結果52例ARDS患者死亡12例,病死率為23.1%;治療48 h後,患者血氧飽和度、pH值、動脈血氧分壓、碳痠氫根顯著高于治療前[(0.89±0.13)比(0.80±0.30)、(7.9±0.7)比(7.1±0.6)、(82.4±6.9) mmHg(1 mmHg=0.133 kPa)比(62.3±7.9) mmHg、(21.2±2.5) mmHg比(19.7±3.9) mmHg],二氧化碳分壓顯著低于治療前[(40.6±6.9) mmHg 比(46.3± 8.4) mmHg,P<0.01]。結論經機械通氣、液體管理、抗炎和抗凝等綜閤措施治療 ARDS患者效果較好,治療前後各項指標均有好轉跡象,可有效降低其病死率。
목적:탐토호흡지지、액체관리、항염화항응등종합방법치료급성호흡군박종합정( ARDS)적료효。방법대2006년1월지2012년12월사천성제사인민의원호흡내과수치적ARDS환자52례,재적겁처리원발병기출상,응용호흡지지、액체관리、항염화항응등종합치료조시,관찰치료전후상관림상지표적변화。결과52례ARDS환자사망12례,병사솔위23.1%;치료48 h후,환자혈양포화도、pH치、동맥혈양분압、탄산경근현저고우치료전[(0.89±0.13)비(0.80±0.30)、(7.9±0.7)비(7.1±0.6)、(82.4±6.9) mmHg(1 mmHg=0.133 kPa)비(62.3±7.9) mmHg、(21.2±2.5) mmHg비(19.7±3.9) mmHg],이양화탄분압현저저우치료전[(40.6±6.9) mmHg 비(46.3± 8.4) mmHg,P<0.01]。결론경궤계통기、액체관리、항염화항응등종합조시치료 ARDS환자효과교호,치료전후각항지표균유호전적상,가유효강저기병사솔。
Objective To explore the application of respiratory support,fluid management,anti-inflam-matory and anticoagulant therapy in treating acute respiratory distress syndrome ( ARDS) .Methods A total of 52 ARDS patients admitted in Sichuan Fourth People′s Hospital from Jan.2006 to Dec.2012 were select-ed.On the basis of active treatment for primary disease,the patients were treated by comprehensive therapies, including respiratory support,fluid management,anti-inflammatory and anticoagulant,the changes of clinical indicators were observed before and after treatment.Results After treatment,12 cases out of 52 died,the mortality rate was 23.1%.And 48 h after treatment,the transcutaneous oxygen saturation,pH value,oxygen partial pressure,bicarbonate of the patients were higher than those before treatment,there were statistically significant differences[(0.89 ±0.13) vs (0.80 ±0.30),(7.9 ±0.7) vs (7.1 ±0.6),(82.4 ±6.9) mmHg vs (62.3 ±7.9) mmHg,(21.2 ±2.5) mmHg vs (19.7 ±3.9) mmHg],while partial pressure of carbon dioxide was significantly lower than that before treatment [(40.6 ±6.9) mmHg vs (46.3 ±8.4) mmHg, P<0.01].Conclusion The comprehensive therapy of mechanical ventilation, fluid management, anti-inflammatory and anticoagulant for ARDS has good effect ,clinical indicators of the patients generally become better after treatment.It can effectively reduce the mortality.