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目的:研究肺保护通气下肺源性急性呼吸窘迫综合征(ARDS)与非肺源性ARDS的早期肺氧合功能和呼吸力学之间的差异。方法:选择2008年7月～2009年8月南京儿童医院PICU收治的ARDS患者21例,其中肺源性ARDS患者10例,非肺源性ARDS患者11例。在肺保护性通气治疗下比较两者在肺氧合功能和呼吸力学之间的差异。结果:肺源性ARDS组和非肺源性ARDS组PaO2和PaO2/FiO2呈上升趋势,与0时间点呈显著性差异(P<0.05);PIP、Pplat呈下降趋势,但各组间无显著性差异;Cst同样随时间呈上升趋势,其中12、24、48h与0时间点有显著性差异(P<0.05);所有观测指标在肺源性ARDS组和非肺源性ARDS组间无显著性差异。结论:在肺保护通气下肺源性ARDS和非肺源性ARDS就肺氧合功能和呼吸力学方面无明显差异。
OBJECTIVE: To study the differences in early pulmonary oxygenation and respiratory mechanics between pulmonary acute respiratory distress syndrome (ARDS) and non-pulmonary ARDS. Methods: Twenty-one patients with ARDS were selected from PICU in Nanjing Children’s Hospital from July 2008 to August 2009, including 10 patients with pulmonary ARDS and 11 patients with non-pulmonary ARDS. Differences between the two groups in lung oxygenation and respiration mechanics were compared under lung-protective ventilation. Results: The PaO2 and PaO2 / FiO2 of pulmonary ARDS group and non-pulmonary ARDS group showed an upward trend compared with the time point of 0 (P <0.05), while PIP and Pplat showed a decreasing trend, but no significant difference between the two groups Cst also showed an upward trend with time, of which 12, 24, 48h and 0 time points were significantly different (P <0.05); all the observations in the pulmonary ARDS group and non-pulmonary ARDS group no significant Sex differences. CONCLUSIONS: There is no significant difference in pulmonary oxygenation and respiration mechanics between pulmonary ARDS and non-pulmonary ARDS under lung protection ventilation.