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目的比较不同潮气量对机械通气患者呼吸机相关性肺炎(VAP)发生率及其预后的影响。方法选择2014年1月-2016年10月入住呼吸监护室(RICU)接受气管插管机械通气的患者32例,随机分为小潮气量[潮气量(VT):6~8 ml/kg]组(A组)和传统潮气量(VT:10~12 ml/kg)组(B组),每组16例,均采用压力调节容量控制-同步间歇指令通气+压力支持通气(PRVC-SIMV+PSV)模式通气,比较2组患者机械通气时间、VAP发生率、机械通气后VAP发生时间、RICU住院时间及28 d病死率。结果 A组机械通气时间和RICU住院时间长于B组,VAP发生率高于B组,VAP发生时间早于B组,差异均有统计学意义(P<0.05)。2组28 d病死率比较差异无统计学意义(P>0.05)。结论应用传统潮气量机械通气可有效预防VAP的发生并改善其预后。
Objective To compare the effects of different tidal volumes on the incidence and prognosis of ventilator-associated pneumonia (VAP) in patients with mechanical ventilation. Methods Thirty-two patients admitted to Respiratory Care Unit (RICU) for mechanical ventilation during tracheal intubation from January 2014 to October 2016 were randomly divided into two groups: low tidal volume (VT): 6-8 ml / kg A group) and traditional tidal volume (VT: 10-12 ml / kg) group (group B), 16 patients in each group were treated with PRVC-SIMV + PSV Mode ventilation, mechanical ventilation time, VAP incidence, VAP time after mechanical ventilation, hospital stay of RICU and 28-day mortality were compared between two groups. Results The duration of mechanical ventilation and RICU stay in group A was longer than that in group B, the incidence of VAP was higher than that in group B, and the occurrence of VAP was earlier than that in group B (P <0.05). There was no significant difference in 28-day mortality between the two groups (P> 0.05). Conclusion The application of traditional tidal volume mechanical ventilation can effectively prevent the occurrence of VAP and improve its prognosis.