摘要
目的探讨甲强龙联合无创正压通气治疗ARDS的临床疗效。方法研究对象为2014年1月~2016年1月于我院重症医学科住院治疗的ARDS患者100例,所有患者均行综合治疗,纠正水和电解质紊乱及酸碱失衡,糖皮质激素甲强龙80 mg/次,2次/d,连用3~5 d,同时行NIPPV治疗。采用美国伟康生产的Bi PAP vision呼吸机,采用面罩进行人机连接。观察患者治疗后1 h、24 h、3 d、7 d的PaO_2/FiO_2、PaO_2、PaCO_2及RR等指标情况;观察患者的撤机成功率、呼吸机相关性肺炎、院内死亡情况。结果 100例ARDS患者甲强龙联合无创正压通气治疗后,显效55例,有效42例,无效3例,总有效率达97%。住院天数(12.6±2.3)d,撤机成功率100%,发生呼吸机相关性肺炎2例(2%),院内死亡1例(1%),死于呼吸衰竭。治疗后1 h、24 h、3 d、7 d,100例ARDS患者的PaO_2/FiO_2、PaO_2、Pa CO2及RR均较治疗前明显改善,差异有统计学意义(P<0.05)。结论甲强龙联合无创正压通气治疗ARDS疗效确切、住院时间短、并发症少,可显著改善患者的通气功能,缓解患者的临床症状,值得推广和应用。
Objective To explore the clinical efficacy of methylprednisolone combined with noninvasive positive pres-sure ventilation in the treatment of ARDS. Methods A total of 100 cases of ARDS treated in the Department of Inten- sive Care Unit in our hospital from January 2014 to January 2016 were selected as the study subjects. All patients un- derwent comprehensive treatment to correct water and electrolyte imbalance and acid-base imbalance, methylpred- nisolone 80 mg/time, 2 times/d for 3-5 days, and NIPPV treatment. BiPAP vision ventilator produced in Wei Kang of the United States was used, and the mask was used for man-machine connection. The levels of PaO2 /FiO2, PaO2, PaCO2 and RR at 1 h, 24 h, 3 d and 7 d after treatment, the success rate of weaning, ventilator-associated pneumonia and hospital deaths were observed. Results In 100 cases of ARDS patients after methylprednisolone combined with NPPV treatment, 55 cases were cured, 42 cases were effective, 3 cases were invalid, with the total effective rate of 97%. The length of hospital stay was（12.6±2.3） d. The success rate of weaning was 100%. Ventilator-associated pneumonia occurred in 2 cases（2%）, and 1 case（1%） died in hospital whodied of respiratory failure. The PaO2 /FiO2 , PaO2 , PaCO2 and RR were significantly improved in the patients with ARDS at 1 h, 24 h, 3 d, 7 d after treatment compared with those before treatment, and the difference was significant（P〈0.05）. Conclusion The combination of methylprednisolone and noninva-sive positive pressure ventilation is effective in the treatment of ARDS, with short hospitalization time and fewer complications, which can significantly improve the ventilation function of patients and relieve the clinical symptoms of pa- tients. It is worthy of promotion and application.
作者
王春宝
刘玉静
司晓明
郑鹏
WANG Chunbao;tIU Yujing;SI Xiaoming;ZHENG Peng(Department of Intensive Care Unit, Zibo Mining Group Co., Ltd Central Hospital, Zibo 225120, China)
出处
《中国现代医生》
2017年第30期71-73,共3页
China Modern Doctor
关键词
甲强龙
无创正压通气
ARDS
通气模式
呼吸机相关性肺炎
Methylprednisolone
Noninvasive positive pressure ventilation
ARDS
Ventilation mode
Ventilator asso- ciated pneumonia
