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目的:探讨肺保护性通气策略在治疗高原儿童急性呼吸窘迫综合征(ARDS)的临床疗效。方法:对2000年1月—2010年1月我省妇女儿童医院收治的35例ARDS患儿的临床资料进行回顾性分析。根据机械通气模式的不同分为肺保护性通气组和传统通气组。观察两组患儿的呼吸机参数设置、血气分析、氧合指数、并发症及死亡率等。结果:肺保护性通气组VT显著下降,PEEP显著升高,呼吸机相关性肺损伤的发生率为5%(1/20),明显低于传统通气组40%(6/15),两组氧合指数比较有明显差异。结论:肺保护性通气策略治疗高海拔地区儿童ARDS较传统方法降低了呼吸机相关性肺损伤的发生率,且能改善氧合,值得临床推广。
Objective: To investigate the clinical efficacy of pulmonary protective ventilation in the treatment of children with acute respiratory distress syndrome (ARDS). Methods: The clinical data of 35 ARDS patients admitted to our Women and Children Hospital from January 2000 to January 2010 were analyzed retrospectively. According to the different modes of mechanical ventilation is divided into lung-protective ventilation group and the traditional ventilation group. Ventilator parameters, blood gas analysis, oxygenation index, complications and mortality were observed in two groups. Results: The VT of pulmonary protective ventilation group decreased significantly, PEEP increased significantly, the incidence of ventilator-associated lung injury was 5% (1/20), significantly lower than 40% (6/15) in traditional ventilation group Oxygenation index was significantly different. Conclusion: Pulmonary protective ventilation strategy in children at high altitude treatment of ARDS compared with the traditional method to reduce the incidence of ventilator-associated lung injury, and can improve oxygenation, is worth clinical promotion.