资源描述：
《压力控制通气治疗重症创伤性湿肺的临床研究》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、压力控制通气治疗重症创伤性湿肺的临床研究【关键词】压力作者：杜伟亚 何建行 惠萍 罗民新 摘要:目的:探讨压力控制通气(PCV)用于治疗创伤性急性呼吸窘迫综合征(ARDS)的临床应用价值。方法:观察创伤性ARDS患者PCV组和容量控制通气(VCV)治疗后6和12h气道峰压(PIP),平均气道压(MPaw)和呼气末正压(PEEP)的大小,并比较PCV治疗对血气、血压和心率的影响。结果:PCV组治疗后6和12hPIP均显著低于VCV组(P均<0.01),6hMPaw和PEEP与VCV比较无显著差异(P均>0.05),而12hPCV组MPaw
2、和PEEP均显著低于VCV组(P<0.05和P<0.01)。PCV组治疗后血气分析、心率和呼吸显著改善,血压无明显变化。结论:PCV治疗创伤性ARDS能显著降低PIP,并不增加MPaw和PEEP值,对血流动力学也无明显影响。 关键词:创伤性湿肺；压力控制通气;容量控制通气 ClinicalResearchonTreatmentofSevereTraumaticWetLungUsingPressureControlledVentilation Abstract:Objective:Tostudythetherapeuticeffect
3、sofpressurecontrolledventilationposttraumaticacute8respiratorydistresssyndrome(ARDS).Method:EighteenpatientswithposttraumaticARDSwereincludedinthestudy.Thepatientsreceivedmechanicalventilationimmediatelyafteradmissionandwererandomlydividedintotwogroups:pressurecontrolledventila
4、tion(PCV)group(n=10)andvolumecontrolledventilation(VCV)group(n=10).Peakairwaypressure(PIP),meanairwaypressure(MPaw)andpositiveend-expiratorypressure(PEEP)at6hour(PTh6)and12hour(PTh12)aftertreatmentinthetwogroupswererecordedandcompared.Bloodgasanalysis,bloodpressure,heartandresp
5、iratoryrateswerecomparedbeforeandafterPCVtreatment.Results:PIPinPCVgroupatPTh6andPTh12were(2.24±0.12)kPa(1kPa=10.20cmH2O)and(1.98±0.08)kPa,respectively,andweresignificantlylowerthanthoseintheVCVgroup(bothP<0.01).TheMPawandPEEPinPCVgroupatPTh6were(1.12±0.09)kPaand(0.79±0.12)k
6、Pa,respectively,andshowednosignificantdifferencewiththoseintheVCVgroup(bothP>0.05).ButthetwoparametersatPTh12inPCVgroup,whichwere(0.85±0.08)kPaand(0.55±0.04)kParespectively,weresignificantlylowerthanthoseintheVCVgroup(P<0.05andP<0.01).Thebloodgasanalysis,heartandrespir
7、atoryrateswereobviouslyimprovedinPCVtreatmentgroup,andnosignificantchangesinbloodpressure8wasobserved.Conclusion:PCVcansignificantlylowerthePIPlevelwithnodisturbancetoMPaw,PEEPandhemodynamics.Itisusefulinthetreatmentofpost-traumaticARDS. Keywords:Traumaticwetlung;Pressurecontr
8、olventilation;Volumecontrolventilation 机械通气尤其是呼气末正压(Ｐ
