| 王晓峰 郭海华 郝智泉 李小飞 高坤祥.低容量负荷对创伤后ARDS肺功能的保护作用研究[J].,2015,15(8):1518-1521 |
| 低容量负荷对创伤后ARDS肺功能的保护作用研究 |
| Protective Effect of Low Volume Load on Lung Dysfunction of Patients withAcute Respiratory Distress Syndrome after Injury |
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| DOI： |
| 中文关键词: 急性呼吸窘迫综合症 液体控制 肺功能 白细胞介素-6 肺泡表面活性蛋白D |
| 英文关键词: Acute respiratory distress syndrome Liquid management Lung protection IL-6 SP-D |
| 基金项目:全军医药卫生科研基金项目(06M264)；陕西省科技攻关项目(2009K18-02-6) |
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| 中文摘要: |
| 目的：观察低容量负荷对创伤后急性呼吸窘迫综合征(ARDS)肺功能的保护作用。方法：165 例创伤后ARDS患者随机分为
液体控制组和对照组，用脉搏指示连续心输出量监测(PiCCO)指导液体控制，观察中心静脉压(CVP)、肺动脉楔压(PAWP)、氧合指
数(PaO2/FiO2)、肺泡- 肺动脉氧分压差，测定肺泡灌洗液中白细胞介素6(IL-6)水平、血清的肺泡表面活性蛋白D(SP-D)水平的变
化，检测呼吸机脱机时间，评估两组患者肺功能的恢复情况。结果：液体控制组血管外肺水肿指数(EVLWI)、CVP、PWAP、IL-6、
SP-D 以及肺泡-动脉氧分压差均较对照组明显下降(P<0.05)，动脉血气氧分压、氧合指数较均对照组明显升高(P<0.05)，机械通气
支持时间较对照组明显缩短(P<0.05)。结论：严格的液体控制可有效降低人体的容量负荷，有效促进创伤后ARDS 肺损伤和肺功
能的恢复，这可能与低容量负荷能够降低炎症反应、促进肺泡复张和改善氧合效率有关。 |
| 英文摘要: |
| Objective:To observe the protective effectof low volume load on the lung dysfunction of patients with acute
respiratory distress syndrome after injury.Methods:165 ARDS patients with trauma were randomly divided into the liquid management
group and control group. PiCCO was used to monitor the liquid management, which consisted of CVP, PAWP, PaO2/FiO2. The
concentration of IL-6 in lung lavage fluid and the concentration of SP-D in plasma were detected before and after curing. Besides, the
arterial blood gas analysis and the weanning time of respirator were recorded.Results:The CVP, PAWP, EVLWI, IL-6 andSP-D
levelsdecreased more obviously in the liquid management group than those in the control group (P<0.05). The oxygen partial pressure of
arterial blood gas increased more obviously in the liquid management group than in the control group(P<0.05). The improvement of lung
function was greater in the liquid management group than in the control group (P<0.05).Conclusion:Low volume loadcouldeffectively
protect pulmonary dysfunction of ARDS patients with injury，which was connected with the reduction ofinflammation and improvement
of oxygen-consuming. |
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