摘要
目的评估肺泡动脉氧分压差（PA-aDO2）对肺部感染致ARDS伴机械通气患者脱机的影响。方法回顾性分析天津市第一中心医院ICU自2015-07～2017-07收治的肺部感染致ARDS伴机械通气患者64例，根据机械通气后第14天患者能否脱机分为脱机成功组和脱机失败组，观察两组年龄、性别、机械通气前血肌酐（cr）、血ALT、血AST、总胆红素（TBil）、氧合指数及PA-aDO2值，并比较两组患者机械通气后第1、3、7、14天氧合指数与PA-aDO2值以及两组患者氧合指数与PA-aDO2的相关性。结果①两组年龄、性别、机械通气前血Cr、血ALT、血AST、TBil、氧合指数、PA-aDO2及机械通气后第1天氧合指数及PA-aDO2差异均无统计学意义（P〉0．05）。②两组在机械通气后的第3、7、14天氧合指数及PA-aDO2差异有统计学意义（P〈0．05），脱机成功组第3、7、14天氧合指数均高于脱机失败组，分别为（163．65-4-25．33）mmHgVS．（112．29±29．95）mmHg、（172．68±22．09）mmHgVS．（121．589±23．35）mmHg、（231．9±37．56）mmHgVS．（115．00±21．69）mmHg；脱机成功组第3、7、14天Ph，D02均低于脱机失败组，分别为（186．65±55．05）mmHgVS．（310．50±51．16）mmHg、（120．41±33．91）mmHgVS．（347．69±50．56）mmHg、（86．38±29．91）mmHgVS．（347．55±49．16）mmHg。③PA-aDO2与氧合指数呈显著负相关（r=-0．698，P=0．000）。结论动态监测肺部感染致ARDS伴机械通气患者PA-aDO2有助于对患者治疗效果及脱机做出预判。
Objective To evaluate the effects of aveolar - artery partial pressure on ARDS patient＇s ventilation weaning which was caused by lung infection. Methods A retrospective analysis of 64 cases who were diagnosed ARDS caused by lung infection and required mechanical ventilation were selected; all patients were admitted to the ICU from July 2015 to July 2017 in our hospital. According to whether patients can wean ventilation or not, we divided these patients into two groups, the successful weaning ventilation group and the failure weaning ventilation group. We observed age, gender, creatinine （Cr）, blood ALT, blood AST, total bilirubin （TBil）, oxygenation index and aveolar- artery partial pressure （ PA -aDO2 ） value of the two groups before mechanical ventilatory, and we also compared the two group＇s oxygenation index and PA-aDO2 values on 1 ,3,7 and 14 day after mechanical ventilatory.The correlation between the oxygenation index and PA_,DO2 was compared in the two groups. Results ①We found that the two group＇s age, genderl serum creatinine （Cr）, blood ALT, AST, total bilirubin （TBil）, oxygenation index and PA-a DO2 values before the mechanical ventilation has no statistical difference, and there also has no statistical difference in oxygenation index and PA-a DO2 values on the first day after mechanical ventilation （ P 〉 0, 05 ）. ②There were statistical differences between the two group＇s oxygenation index and PA-aDO2 values on the 3, 7, 14 day after mechanical ventilation （P 〈 O. 05 ）, the successful weaning ventilation group＇s oxygenation index was higher than that of the failure weaning ventilation group. The numbers were （ 163. 65 ± 25. 33 ） mm Hg vs. （ 112. 29 ± 29.95 ） mmHg, （172.68±22.09） mm Hgvs. （121.589±23.35） mm Hg, （231.9±37.56） mm Hgvs. （115.00±21.69） mm Hg, and it＇s PA-aCO2 values were lower, the numbers were （186.65 ± 55.05 ） mmHgvs. （310.50±51.16） mm Hg, （120.41±33.91） mm Hg vs. （ 347. 69 ±50. 56 ） mm Hg
出处
《中国急救医学》
CAS
CSCD
北大核心
2018年第1期76-79,共4页
Chinese Journal of Critical Care Medicine
