高频通治疗胸部创伤合并急性呼吸窘迫综合征
目的探讨高频通气(high frequency ventilation,HFV)治疗胸部创伤合并急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的临床应用价值.方法对该院1999年6月以来胸部创伤合并ARDS的患者随机分为治疗组与对照组,治疗组30例应用HFV,对照组26例应用常频机械通气(conventionalmechnical ventilation,CMV),通过监测氧合指数OI(PaO2/FiO2)、动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)等参数,评估HFV治疗重症胸部创伤合并ARIDS的治疗效果及临床应用价值.结果治疗组应用HFV治疗前后比较,OI、PaO,在应用HFV 4 h后均显著提高(P＜0.01).两组患者对比,OI在治疗前及治疗2h后差异无显著性(P＞0.05),在治疗4、8、16、24 h及48 h后差异有显著性(P＜0,05);PaCO2在治疗前及治疗2 h后差异无显著性(P＞0.05),在治疗4 h后差异有显著性(P＜0.05)、8 h后均有显著差异(P＜0.01).HFV组病死率为40.0%.结论HFV能够促进胸部创伤合并ARDS患者的肺脏通气,有效改善氧合、纠正低氧血症;同CMV对比,HFV改善氧合、提高OI的疗效更加显著,在应用HFV 4 h后可引起CO2的轻度潴留;HFV有助于胸部创伤合并ARDS患者的急救,值得临床推广应用、深入研究.关键词：高频通气;胸部创伤;急性呼吸窘迫综合征
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用过国产的高频喷射通气机，觉得效果并不好。目前，各种先进的国外呼吸机性能非常好，各种通气模式结合使用，可以很好地改善ARDS患者氧合指数，譬如：BiPAP，SIMV+PS，等。
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