摘要
目的探讨损伤控制外科(DCS)与无创正压通气(NIPPV)在多发性骨折合并急性呼吸窘迫综合征(ARDS)中的应用效果。方法选取2010年3月至2012年4月重庆市肿瘤研究所收治的多发性骨折合并ARDS患者50例作为研究对象,依据DCS理念治疗,同时给予NIPPV辅助治疗,观察患者的生命体征、血气分析以及氧代谢参数变化,评价治疗效果。结果 50例多发性骨折合并ARDS患者经过治疗后恢复情况良好,均痊愈出院。患者治疗后APACHEⅡ评分以及ISS评分显著高于治疗前(P<0.05)。应用NIPPV治疗后患者呼吸频率、收缩压、舒张压、心率、PaO2、PaCO2,氧代谢参数PaO2/FiO2、氧供、氧耗、肺内静动脉血分流等指标显著优于治疗前(P<0.05)。结论多发性骨折合并ARDS的患者在DCS策略下应用NIPPV技术可以明显改善患者的肺通气状态,改善患者预后。
Objective To explore the effect of DCS and NIPPV on the multiple fractures complicated with acute respiratory distress syndrome（ ARDS）. Methods Fifty cases of mnhiple fractures with ARDS patients frum Chongqing Cancer Institute during Mareh 2010 and April 2012 were selected. Aecurding to DCS, non invasive positive pressure ventilation （NIPPV） therapy was giwm, and vital signs, hlood gas analysis aml oxygen metahulism parameters,therapeutic effect were observed and evaluated. Results All of the 50 eases of multiple fractures with ARDS recovered well after treatment. APACHE score and ISS score after treatment were higher than those before treatment ,with statistically significant differences （P 〈 0.05 ）. RR, SBP, DBP, HR, PaO2 , PaCO2 and the oxygen metabolic parameters of PaO2/FiO2 , DO2 , VO2 , Qs/Qt index after the application of NIPPV were significantly better than before treatment（ P 〈 0.05 ）. Conclusion Multiple fractures with ARDS can be significantly improved by NIPPV technology guided by DCS strategy which can significantly improve the puhnonary ventilation condition and the prognosis.
出处
《医学综述》
2013年第21期3990-3992,共3页
Medical Recapitulate
关键词
多发性骨折
急性呼吸窘迫综合征
损伤控制外科
无创正压通气
Multiple fractures
Acute respiratory distress syndrome
Damage control surgery
Non invasive positive pressure ventilation
