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目的:观察小潮气量、最佳呼气末正压(PEEP)联合肺复张策略治疗急性呼吸窘迫综合症(ARDS)患者的效果。方法:将36例ARDS患者随机分成对照组和治疗组各18例,对照组采用小潮气量、最佳PEEP方案治疗;治疗组在小潮气量、最佳PEEP方案基础上联合应用肺复张策略,观察两组不同时间氧合指数(PaO_2/FiO_2)及FiO_2、潮气量、PEEP的变化。结果:治疗组在肺复张策略后12 h、24 h、72 h氧合指数明显改善,与对照组比较具有显著性差异(P<0.05),而两组发生气压伤无明显差异(P>0.05);且不增加死亡率及患者对呼吸机参数的要求。结论:肺复张策略联合小潮气量、最佳PEEP治疗急性呼吸窘迫综合症安全有效。
Objective: To observe the effect of small tidal volume, optimal positive end expiratory pressure (PEEP) combined with pulmonary reexpansion strategy on patients with acute respiratory distress syndrome (ARDS). Methods: Thirty-six patients with ARDS were randomly divided into control group and treatment group, 18 cases in each group. The control group was treated with low tidal volume and the best PEEP regimen. The treatment group was treated with combination of small tidal volume and optimal PEEP regimen. Changes of oxygenation index (PaO_2 / FiO_2), FiO_2, tidal volume and PEEP in two groups at different time. Results: The oxygenation index of the treatment group at 12 h, 24 h and 72 h after lung recanalization strategy was significantly improved (P <0.05), but there was no significant difference between the two groups (P> 0.05); and did not increase the mortality rate and patient requirements for ventilator parameters. Conclusion: The strategy of pulmonary reexpansion combined with low tidal volume, the best PEEP treatment of acute respiratory distress syndrome is safe and effective.