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目的观察肺复张(RM)对患者重大手术后肺部感染的预防作用。方法对重大手术后患者随机分为两组,对照组(n=22例)采用小潮气量和最佳呼吸末正压(PEEP)的肺保护性通气策略进行机械通气,治疗组(n=23例)在对照组机械通气治疗基础上再应用肺复张策略治疗。记录RM前和末次RM 2 h动脉血气,计算患者氧合指数(PO2/FiO2),跟踪记录两组患者病死率、肺部感染发生率和平均住重症加强治疗病房(ICU)时间。结果治疗组肺部感染发生率和平均住ICU时间明显短于对照组(P<0.05),两组病死率比较差异无统计学意义(P>0.05)。结论对重大手术后患者实施肺复张可减少肺部感染发生率、缩短患者住院时间,减少住院费用,在临床上具有十分重要的意义。
Objective To observe the preventive effect of lung recruitment (RM) on pulmonary infection after major surgery. Methods Patients after major surgery were randomly divided into two groups. The control group (n = 22) was ventilated by lung protective ventilation with low tidal volume and optimal positive end-expiratory pressure (PEEP). The treatment group (n = 23 ) In the control group on the basis of mechanical ventilation and then the application of pulmonary recurrent strategy treatment. The arterial blood gas was recorded before and at the last RM 2 h. The oxygenation index (PO2 / FiO2) of the patients was recorded. The case fatality rate, incidence of pulmonary infection and mean intensive care unit (ICU) time were recorded. Results The incidence of pulmonary infection and ICU stay in the treatment group was significantly shorter than that in the control group (P <0.05). There was no significant difference in mortality between the two groups (P> 0.05). Conclusions The implementation of pulmonary reexpansion in patients after major surgery can reduce the incidence of pulmonary infection, shorten the hospitalization time and reduce the cost of hospitalization, which is of clinical significance.