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目的 探讨呼气末二氧化碳(PETCO2)联合吸气平台压力监测在急性呼吸窘迫综合征(ARDS)机械通气患者中的应用效果.方法 随机选取肇庆市第一人民医院重症医学科收治的60例ARDS机械通气患者,采用随机数字表法分为治疗组和对照组.治疗组应用PETCO2联合平台压监测指导ARDS机械通气参数的设置,对照组应用6 ml/kg的小潮气量机械通气.比较两组患者抢救成功率和死亡率等.结果 治疗7 d后,治疗组的动脉血氧分压(PaO2)、氧合指数较对照组显著升高(P<0.05),而C反应蛋白(CRP)以及降钙素原(PCT)水平较对照组明显降低(P<0.05);治疗组治疗1、3、7、14 d时的APACHEⅡ评分较对照组显著降低(P<0.05);治疗组体征改善率和治愈率分别为73.33%、53.33%,对照组仅为33.33%、16.67%(P<0.05);治疗组的死亡率为3.33%,而对照组高达20.00%(P<0.05);治疗组的并发症发生率、住院时间和平均花费均明显低于对照组(P<0.05).结论 采用PETCO2联合吸气平台压力监测在ARDS机械通气患者中效果显著,值得大力推广使用.“,”Objective To study the effect of end tidal carbon dioxide combined with the plat pressure monitoring in acute respiratory distress syndrom(ARDS) patients with mechanical ventilation. Methods 60 ARDS patients with mechanical ventilation in the first people′s Hospital of Zhaoqing city were randomly selected ,and were randomly divided into treatment group and control group. The mechanical ventilation parameters of the treatment group was guided by monitoring end expiratory CO2(PETCO2)combined plat pressure,and the control group was treated with 6 ml/kg of mechanical ventilation with low tidal volume. The success rate of rescue and mortality of two groups were observed and compared of patients with. Results After treatment,the PaO2 and oxygenation index of treatment group were significantly higher than those in control group,and C?reactive protein(CRP)and calcitonin angiotensinogen(PCT)levels decreased significantly than that of the control group;APACHE Ⅱ score after treatment for 1 d,3 d,7 d,and 14 d in treatment group was significantly lower than those in control group;the improvement rate and cure rate of the treatment group were 73.33% and 53.33%,respectively , while those of the control group were 33.33% and 16.67%,respectively;the mortality rate in the treatment group was 3.33%, while that of the control group was as high as 20.00%;in treatment group , the complications incidence , hospitalization time and average cost were significantly lower than those in the control group. The differences of the two groups were statistically significant (P<0.05).Conclusion The effect of end tidal carbon dioxide combined with the plat pressure monitoring in ARDS patients with mechanical ventilation was significant ,and it is worth to be popularized.