| 茆伟伟,冯伟生,薄 义,赵丽丽,郎娅淞.间歇性叹息与渐进式肺复张策略对肺萎陷相关ARDS患者呼吸功负荷与氧合指数改善效果的比较[J].,2025,(18):2996-3002 |
| 间歇性叹息与渐进式肺复张策略对肺萎陷相关ARDS患者呼吸功负荷与氧合指数改善效果的比较 |
| Comparison of the Effect of Intermittent Sighing and Progressive Lung Recruitment Strategy on the Improvement of Respiratory Work Load and Oxygenation Index in Patients with ARDS Related to Lung Collapse |
| 投稿时间：2025-03-29 |
| DOI：10.13241/j.cnki.pmb.2025.18.016 |
| 中文关键词: 急性呼吸窘迫综合征 肺萎陷 间歇性叹息 渐进式肺复张 呼吸功负荷 氧合指数 |
| 英文关键词: Acute respiratory distress syndrome Lung collapse Intermittent sighing Progressive lung retraction Respiratory work load Oxygenation index |
| 基金项目:江苏省卫生健康委科研项目（Z2020061） |
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| 中文摘要: |
| 摘要 目的：探讨间歇性叹息与渐进式肺复张策略对肺萎陷相关急性呼吸窘迫综合征（ARDS）患者呼吸功负荷与氧合指数改善效果的差异。方法：选取2020年1月至2024年1月收治的60例肺萎陷相关ARDS患者，依据治疗方法不同分为间歇性叹息组（IS组，n=30）和渐进式肺复张组（PLR组，n=30）。IS组采用间歇性叹息通气模式，PLR组采用渐进式肺复张策略。比较两组患者治疗前后的呼吸功负荷指标变化[包括呼吸做功（WOB）、最大吸气压（Pmax）、经皮氧饱和度（SpO2）]、氧合指数（PaO2/FiO2）、肺顺应性（Cst）、呼吸力学指标及机械通气相关参数变化情况。结果：两组治疗后呼吸功负荷明显降低，PLR组WOB下降更显著（P<0.05）；两组氧合指数均显著提高，且PLR组改善程度更显著（P<0.01）；PLR组肺顺应性改善更明显（P<0.05）；PLR组机械通气时间及ICU住院时间显著短于IS组（P<0.05）。结论：渐进式肺复张策略较间歇性叹息通气在改善肺萎陷相关ARDS患者呼吸功负荷、提高氧合指数及肺顺应性方面效果更佳，可更有效缩短患者机械通气时间及ICU住院时间，值得临床推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the differences in respiratory work load and oxygenation index improvement between intermittent sighing and progressive lung retraction strategies in patients with acute respiratory distress syndrome (ARDS) related to lung collapse. Methods: Sixty patients with ARDS related to lung collapse admitted from January 2020 to January 2024 were selected and divided into intermittent sighing group (IS group, n=30) and progressive lung re-expansion group (PLR group, n=30) according to different treatment methods. The IS group used an intermittent sighing ventilation mode, while the PLR group adopted a progressive lung re-expansion strategy. The changes in respiratory work load indicators [including work of breathing (WOB), maximum inspiratory pressure (Pmax), transcutaneous oxygen saturation (SpO2)], oxygenation index (PaO2/FiO2), lung compliance (Cst), and mechanical ventilation-related parameters were compared before and after treatment in both groups. Results: After treatment, the respiratory work load was significantly reduced in both groups, with a more pronounced decrease in WOB in the PLR group (P<0.05); both groups showed significant improvements in oxygenation index, but the degree of improvement was more marked in the PLR group (P<0.01); lung compliance improved more markedly in the PLR group (P<0.05); the PLR group had significantly shorter mechanical ventilation time and ICU stay compared to the IS group (P<0.05). Conclusion: The progressive lung recruitment strategy is better than the intermittent sighing ventilation in improving the respiratory work load, oxygenation index and lung compliance of patients with ARDS related to lung collapse. It can shorten the mechanical ventilation time and ICU hospital stay more effectively, which is worth clinical promotion and application. |
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