本文選題：急性呼吸窘迫綜合征 + 氧合指數(shù)　； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討特定通氣條件下氧合指數(shù)(PaO2/Fi O2)及其改善值對(duì)急性呼吸窘迫綜合征(ARDS)患者預(yù)后的評(píng)估價(jià)值。方法:將新疆醫(yī)科大學(xué)第一附屬醫(yī)院重癥醫(yī)學(xué)科2015年3月至2016年5月收治的中重度ARDS患者27例進(jìn)行前瞻性研究。收集臨床資(包括性別、年齡、病因、誘因、合并基礎(chǔ)疾病、血?dú)夥治觥⒀Ｒ?guī)、電解質(zhì)、肝腎功、凝血、血壓、心率等生命體征、機(jī)械通氣方式、通氣時(shí)間、ICU滯留時(shí)間、總住院時(shí)間、急性生理學(xué)和慢性健康狀況評(píng)分系統(tǒng)Ⅱ(APACHEⅡ)評(píng)分、序貫器官衰竭估計(jì)評(píng)分(SOFA)評(píng)分、是否發(fā)生MODS累及器官數(shù)目、預(yù)后等)。診斷ARDS并機(jī)械通氣24 h后,在固定的通氣方式下通氣30 min,檢測(cè)動(dòng)脈血?dú)狻Ｓ^察患者28 d生存率,并分為生存組和死亡組。結(jié)果:入選27例中重度ARDS患者,其中、重度患者分別為22例、5例。特定通氣條件下通氣后PaO2/FiO2高于入組時(shí)[172.83±60.65比140.54±41.87(mm Hg,1mmHg=0.133kPa),P=0.01],PaO2/FiO2≤300且200mmHg者、PaO2/FiO2≤200且100mmHg者分別為8例、19例。28d死亡12人,病死率44.4%。與死亡組相比,生存組APACHEⅡ評(píng)分較低(22.75±2.6比18.33±3.4,P=0.010),SOFA評(píng)分較低(9.53±1.9比12.0±2.5,P=0.034),特定通氣條件下通氣后PaO2/FiO2較高[193.79±66.4比146.6±41.5(mm Hg),P=0.01],特定條件通氣后PaO2/FiO2改善值較高[62.36±50.39比2.12±70.60(mmHg),P=0.022]。結(jié)論:特定通氣條件下的氧合指數(shù)及其改善值能反應(yīng)ARDS患者病情和評(píng)估預(yù)后。
[Abstract]:Objective: to evaluate the value of PaO2 / FiO2) and its improvement in the prognosis of ARDS patients with acute respiratory distress syndrome (ARDS) under specific ventilation conditions. Methods: from March 2015 to May 2016, 27 patients with moderate and severe ARDS in the Department of intensive Medicine, the first affiliated Hospital of Xinjiang Medical University, were studied prospectively. To collect clinical information (including sex, age, etiology, inducement, complicated basic diseases, blood gas analysis, blood routine examination, electrolyte, liver and kidney function, coagulation, blood pressure, heart rate and other vital signs, mechanical ventilation mode, ventilation time, etc. Total hospitalization time, acute physiology and chronic health status scoring system 鈪，

本文編號(hào)：1979341