呼吸机致肺损伤与肺保护性策略
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呼吸机致肺损伤与肺保护性策略的临床分析
罗良贤 李凯 魏自香 李凤珠 王志英
(郴州市第一人民医院急诊科，湖南 郴州 423000)
[摘要] 目的 探讨呼吸机所致的肺损伤因素与肺保护性策略。方法 将我院2004年2月至2006年11月将使用呼吸机并出现肺损伤的21例患者作为A组，另随机选出27例病情一致(肺损伤评分、APACHEⅡ)用呼吸机治疗而无肺损伤的患者作为B组，进行回顾性分析.比较两组患者的气道压力、潮气量、PEEP与PaCO2、中性粒细胞、呼吸频率和吸气流速。结果 A组中的气道压力、潮气量、流速和中性粒细胞要高于B组。而B组病人一般存在高碳酸血症。结论 低潮气量、低流速、适当的PEEP、允许性的高碳酸血症有助于预防呼吸机所致的肺损伤。值得临床推广。
[关键词] 肺保护性策略 呼吸机致肺损伤 气压伤 容积伤 肺萎缩伤 肺生物学伤
clinical analysis of lung protective strategy for ventilator-induced lung injury
Luo Liang-xian Wang Zhi-ying
(Department of Emergency Chenzhou NO.1 people's hospital Hunan 423000,P.R.China ).
[Abstract] Objective To explore the factor of ventilator-induced lung injury for lung protective strategy. Method 21 patients with ventilator-induced lung injury were called A group. 27 patients with same pathogenetic condition(score of injury of lungs, APACHEⅡ) and no ventilator-induced lung injury were random selected called B group from February 2004 to November 2006. Compared with airway pressure, tidal volume, neutrophile granulocyte, PEEP, PaCO2, breathing rate and peak flow in the two group. Results Airway pressure, tidal volume, neutrophile granulocyte, breathing rate and peak flow in A group were high in A group. There was permissive hypercapnia in B group. Conclusion .Low Airway pressure, Low tidal volume, low breathing rate and peak flow, proper PEEP and permissive hypercapnia have prevented beforehand from ventilator-induced lung injury. Which is worth spreading clinically. ......
罗良贤 李凯 魏自香 李凤珠 王志英
(郴州市第一人民医院急诊科，湖南 郴州 423000)
[摘要] 目的 探讨呼吸机所致的肺损伤因素与肺保护性策略。方法 将我院2004年2月至2006年11月将使用呼吸机并出现肺损伤的21例患者作为A组，另随机选出27例病情一致(肺损伤评分、APACHEⅡ)用呼吸机治疗而无肺损伤的患者作为B组，进行回顾性分析.比较两组患者的气道压力、潮气量、PEEP与PaCO2、中性粒细胞、呼吸频率和吸气流速。结果 A组中的气道压力、潮气量、流速和中性粒细胞要高于B组。而B组病人一般存在高碳酸血症。结论 低潮气量、低流速、适当的PEEP、允许性的高碳酸血症有助于预防呼吸机所致的肺损伤。值得临床推广。
[关键词] 肺保护性策略 呼吸机致肺损伤 气压伤 容积伤 肺萎缩伤 肺生物学伤
clinical analysis of lung protective strategy for ventilator-induced lung injury
Luo Liang-xian Wang Zhi-ying
(Department of Emergency Chenzhou NO.1 people's hospital Hunan 423000,P.R.China ).
[Abstract] Objective To explore the factor of ventilator-induced lung injury for lung protective strategy. Method 21 patients with ventilator-induced lung injury were called A group. 27 patients with same pathogenetic condition(score of injury of lungs, APACHEⅡ) and no ventilator-induced lung injury were random selected called B group from February 2004 to November 2006. Compared with airway pressure, tidal volume, neutrophile granulocyte, PEEP, PaCO2, breathing rate and peak flow in the two group. Results Airway pressure, tidal volume, neutrophile granulocyte, breathing rate and peak flow in A group were high in A group. There was permissive hypercapnia in B group. Conclusion .Low Airway pressure, Low tidal volume, low breathing rate and peak flow, proper PEEP and permissive hypercapnia have prevented beforehand from ventilator-induced lung injury. Which is worth spreading clinically. ......