摘要
目的探究小潮气量(VT)机械通气对急诊多发伤合并胸部创伤窒息患者的治疗效果。方法65例急诊多发伤合并胸部创伤窒息患者,随机分为研究组(33例)和对照组(32例)。两组患者经镇静、止血等基础治疗后,对照组采用常规潮气量(10~12 ml/kg)机械通气,研究组采用小潮气量(6~8 ml/kg)机械通气。比较两组患者通气前后的动脉血气指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧饱和度、pH值]、静脉血清炎症因子[降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)],疗效及预后。结果通气后,两组患者PaO_(2)、氧饱和度、pH值高于本组通气前,PaCO_(2)低于本组通气前,且研究组患者PaO_(2)、氧饱和度、pH值高于对照组,PaCO_(2)低于对照组,差异具有统计学意义(P<0.05)。通气后,两组患者PCT、CRP、TNF-α、IL-6水平均低于本组通气前,且研究组患者低于对照组,差异具有统计学意义(P<0.05)。研究组患者机械通气时间(7.32±1.52)d、住院时间(11.24±3.23)d短于对照组的(8.96±2.11)、(13.35±3.97)d,出院时创伤严重程度(ISS)评分(7.26±1.97)分低于对照组的(9.13±2.78)分,差异具有统计学意义(P<0.05)。结论小潮气量机械通气用于治疗急诊多发伤合并胸部创伤窒息患者具有显著疗效,可改善患者动脉血气指标,降低炎症反应,值得临床推广应用。
Objective To investigate the therapeutic effect of low tidal volume (VT) mechanical ventilation on emergency patients with multiple trauma and traumatic asphyxia. Methods A total of 65 cases of emergency patients with multiple trauma and traumatic asphyxia were randomly divided into research group(33 cases) and control group (32 cases). After basic treatment of sedation and hemostasis, the control group was given conventional tidal volume (10-12 ml/kg) mechanical ventilation, and the research group was given low tidal volume (6-8 ml/kg) mechanical ventilation. Both groups were compared in terms of arterial blood gas indexes[arterial partial pressure of oxygen (PaO_(2)), arterial partial pressure of carbon dioxide (PaCO_(2)), oxygen saturation,pH], venous serum inflammatory factors [procalcitonin (PCT), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)], clinical efficacy and prognosis. Results After ventilation, the PaO_(2),oxygen saturation and pH of the two groups were higher than those of this group before ventilation, and the PaCO_(2) was lower than that of this group before ventilation;the PaO_(2), oxygen saturation and pH of the research group were higher than those of the control group, and the PaCO_(2) was lower than that of the control group;all the differences were statistically significant (P<0.05). After ventilation, the levels of PCT, CRP, TNF-ɑ, and IL-6 in the two groups were lower than those before ventilation in this group, and the research group were lower than the control group. All the differences were statistically significant (P<0.05). The mechanical ventilation time (7.32±1.52) d and hospitalization time (11.24±3.23) d in the research group were shorter than (8.96±2.11) and (13.35±3.97) d in the control group, and the injury severity scale (ISS) score at discharge (7.26±1.97) points was lower than(9.13±2.78) points in the control group. All the differences were statistically significant (P<0.05). Conclusion Low tidal volume mechanical ventilation has significant efficacy on emergency patients with multiple trauma and traumatic asphyxia, and it can improve arterial blood gas indexes and reduce inflammatory response in patients,which is worthy of clinical promotion and application.
作者
金勇军
JIN Yong-Jun(Emergency Department,Emergency Center of Heze Municipal Hospital,Heze 274000,China)
出处
《中国实用医药》
2022年第11期51-54,共4页
China Practical Medicine
关键词
小潮气量机械通气
急诊多发伤
胸部创伤窒息
治疗效果
Low tidal volume mechanical ventilation
Multiple trauma in emergency department
Traumatic asphyxia
Therapeutic effect
