贵州医科大学学报

2016, v.41;No.189(06) 725-728

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浅低温疗法对老年急性呼吸窘迫患者呼吸功能的影响
Effect of Shallow Hypothermia Therapy on Respiratory Function in Elderly Patients with Acute Respiratory Distress Syndrome

黄海涛;张华;
HUANG Haitao;ZAHNG Hua;Department of Respiratory Medicine,the Fifth People's Hospital of Chengdu;Department of Gastroenterology,the Fifth People's Hospital of Chengdu;

摘要(Abstract):

目的:探讨浅低温疗法对老年急性呼吸窘迫(ARDS)患者肺循环及呼吸功能的影响。方法:老年ARDS患者132例,采用随机数表法分为观察组与对照组,每组66例;对照组行常规机械通气、抗感染以及ARDS支持治疗,观察组在对照组基础上行浅低体温控制,比较两组患者血管外肺水含量(EVLW)、肺循环阻力(PVR)、右室每搏功指数(RVSWI)、平均肺动脉压(MPAP),并统计两组患者机械通气时间及肺灌洗液中IL-6及白蛋白水平。结果:观察组患者机械通气时间以及呼吸机支持力度明显低于对照组,差异具有统计学意义(P<0.05);观察组患者MPAP、PVR、RVSWI及EVLW水平明显低于对照组,并且灌洗液中IL-6及灌洗液白蛋白/血浆白蛋白水平两组比较差异有统计学意义(P<0.05);观察组患者死亡率明显低于对照组,差异有统计学意义(P<0.05)。结论:采用浅低温疗法治疗老年ARDS可有效改善患者肺循环及呼吸功能。
Objective: To investigate the effect of superficial hypothermia therapy on pulmonary circulation and respiratory function in elderly patients with acute respiratory distress syndrome( ARDS).Methods: A total of 132 patients with ARDS were divided into observation group and control group by using random number table method,66 cases in each group. Patients in control group received conventional mechanical ventilation,anti-infection and ARDS support treatment,besides these treatment,the observation group accepted shallow hypothermia therapy. External vascular and lung water content( EVLW),pulmonary circulation resistance( PVR),right ventricular stroke work index( RVSWI)and mean pulmonary artery pressure( MPAP) were compared between the two groups. Mechanical ventilation time,IL-6 and albumin levels of bronchoalveolar lavage fluid were observed. Results: Mechanical ventilation time and ventilator support strength in observation group were significantly lower than those in control group( P < 0. 05); the PVR,RVSWI,EVLW and MPAP levels in the observation group were significantly lower than those in the control group( P < 0. 05); and there was significant difference of IL-6 and the ratio of albumin in bronchoalveolar lavage fluid and plasma albumin between the two groups( P < 0. 05). Mortality in observation group were significantly lower than those in control group( P < 0. 05). Conclusion: Superficial hypothermia therapy can effectively improve the pulmonary circulation and respiratory function of the elderly with ARDS.

关键词(KeyWords): 呼吸道疾病;肺循环;低温;呼吸功能试验
respiratory tract disease;pulmonary circulation;hypothermia;respiratory function tests

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作者(Author): 黄海涛;张华;
HUANG Haitao;ZAHNG Hua;Department of Respiratory Medicine,the Fifth People's Hospital of Chengdu;Department of Gastroenterology,the Fifth People's Hospital of Chengdu;

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DOI: 10.19367/j.cnki.1000-2707.2016.06.024

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