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目的:探讨机械通气在治疗肾移植术后卡氏肺孢菌肺炎(PCP)合并急性呼吸窘迫综合征(ARDS)中的价值。方法:9例肾移植术后PCP合并ARDS患者,在早期抗卡氏肺孢子虫治疗、调整免疫抑制方案等综合治疗措施的基础上,全部给予机械通气治疗,观察其疗效。结果:9例患者中7例有效,有效率为77.78%,2例死亡,死亡率为22.22%。9例患者治疗后2,12,24,48及72h的动脉血氧分压、氧合指数及呼吸频率较治疗前均有改善(均为P<0.05)。结论:机械通气可在短时间内纠正缺氧保证氧合,为治疗原发病赢得时间,在治疗肾移植术后PCP合并ARDS患者的治疗中具有重要的意义。
Objective: To investigate the value of mechanical ventilation in the treatment of pneumocystis carinii pneumonia (PCP) complicated with acute respiratory distress syndrome (ARDS) after renal transplantation. Methods: Nine patients with PCP and ARDS after renal transplantation were treated with mechanical ventilation and observed the curative effect on the basis of early treatment against Pneumocystis carinii and adjustment of immunosuppressive regimen. Results: Seven of the nine patients were effective, the effective rate was 77.78%, two died and the mortality rate was 22.22%. The arterial partial pressure of oxygen, oxygenation index and respiratory rate at 9th, 9th, 12th, 24th, 48th and 72th hour after treatment were all improved (all P <0.05). Conclusion: Mechanical ventilation can correct hypoxia and ensure oxygenation in a short period of time. It is of great importance to treat patients with primary disease and to treat patients with PCP complicated with ARDS after renal transplantation.