摘要
目的探讨氨溴索辅助气道压力释放通气(APRV)治疗急性呼吸窘迫综合征(ARDS)的临床疗效,同时分析该种治疗方案对患者呼吸力学、血气指标的影响。方法本研究为前瞻性研究,选取2020年1月至2022年12月浙江省金华市人民医院接收APRV治疗的128例ARDS患者。在通气过程中,按不同治疗方法分为对照组和研究组,每组均为64例,分别联合0.9%氯化钠注射液和氨溴索注射液辅助治疗。对比2组患者疗效,分析患者呼吸力学、血气指标变化。结果研究组总有效率[90.6%(58/64)与76.6%(49/64)]优于对照组(P<0.05)。治疗3 d后,2组平均气道压(Pmean)、呼吸系统顺应性(Crs)均较治疗前升高,平台压较治疗前降低,且治疗后研究组Pmean、Crs高于对照组,平台压低于对照组(P<0.05)。从趋势图看,2组血气指标均在治疗3 d内出现波动,各指标在时点水平上的差异有统计学意义(P<0.05)。治疗前及治疗后24 h,2组血气指标差异无统计学意义(P>0.05);治疗后48 h、72 h,2组动脉血血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))均较治疗前升高,动脉血二氧化碳分压(PaCO_(2))较治疗前降低,且研究组SaO_(2)、PaO_(2)、PaO_(2)/FiO_(2)高于对照组,PaCO_(2)低于对照组(P<0.05)。结论在ARDS治疗中采取APRV辅助呼吸可以帮助患者改善症状,联合氨溴索治疗可以提高临床总疗效,并进一步改善呼吸力学和血气指标。
Objective To investigate the clinical efficacy of ambroxol assisted airway pressure release ventilation(APRV)in the treatment of acute respiratory distress syndrome(ARDS),and to analyze the effects of this treatment on respiratory mechanics and blood gas indexes of patients.Methods This study was a prospective study.A total of 128 ARDS patients who received APRV treatment at Jinhua People′s Hospital from January 2020 to December 2022 were selected.During the ventilation process,patients were divided into a control group and a study group according to different treatment methods,with 64 cases in each group.The control group received saline solution as adjuvant therapy,while the study group received ambroxol injection as adjuvant therapy.The efficacy,respiratory mechanics,and changes in blood gas indicators were analyzed and compared between the two groups.Results The total effective rate in the study group was significantly higher than that in the control group[90.6%(58/64)vs 76.6%(49/64),P<0.05].After 3 days of treatment,both Pmean and Crs in both groups increased compared to before treatment,while Pplat decreased.Additionally,after treatment,Pmean and Crs in the study group were significantly higher than those in the control group,while Pplat was significantly lower(P<0.05).According to the trend chart,there were significant fluctuations in blood gas indicators in both groups within 3 days of treatment,and there were statistical differences in the level of each indicator at different time points(P<0.05).There was no statistical difference in blood gas indicators between the two groups before treatment and at 24 hours after treatment(P>0.05).At 48 hours and 72 hours after treatment,both groups showed an increase in SaO_(2),PaO_(2),and PaO_(2)/FiO_(2)compared to before treatment,while PaCO_(2)decreased.In addition,the study group had higher SaO_(2),PaO_(2),and PaO_(2)/FiO_(2)and lower PaCO_(2)compared to the control group(P<0.05).Conclusion APRV-assisted ventilation in the treatment of ARDS can help patients imp
作者
王玫
汤小斌
Wang Junmei;Tang Xiaobin(Department of Emergency,People Hospital of Jinhua City,Jinhua,Zhejiang 321000,China)
出处
《中国药物与临床》
CAS
2024年第17期1137-1141,F0003,共6页
Chinese Remedies & Clinics
关键词
呼吸窘迫综合征
连续气道正压通气
氨溴索
治疗结果
呼吸力学
血气指标
Respiratory distress syndrome
Continuous positive airway pressure
Ambroxol
Treatment outcome
Respiratory mechanics
Blood gas index
