【摘要】：目的:探討控制性肺膨脹(SI)對急性呼吸窘迫綜合征(acute respiratory distress syndrome,ARDS)機(jī)械通氣患者容量反應(yīng)性的預(yù)測價(jià)值。方法:將2016年3月至12月在丹陽市人民醫(yī)院重癥醫(yī)學(xué)科行機(jī)械通氣的ARDS患者納入研究。監(jiān)測患者SI前后的血流動力學(xué)變化,15 min進(jìn)行補(bǔ)液試驗(yàn)(FC),根據(jù)心指數(shù)變化值(ΔCI)將其分為有容量反應(yīng)性組(FR組,ΔCI≥10%)和無容量反應(yīng)性組(NFR組,ΔCI10%)。統(tǒng)計(jì)學(xué)分析SI時(shí)可預(yù)測容量反應(yīng)性的指標(biāo),并評估其診斷價(jià)值。結(jié)果:本研究共納入40例患者(FR組22例,NFR組18例)。與SI前相比,FR組SI后CI(2.90±0.24 vs 2.61±0.24)、收縮壓(SBP)[(102.4±8.0)mm Hg vs(94.0±8.6)mm Hg]差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。SI-ΔCI、SI-ΔSBP評估容量反應(yīng)性的ROC分別為0.934、0.851,敏感度均為90.9%,特異度分別為88.9%、77.8%。結(jié)論:SI-ΔCI、SI-ΔSBP可用于評估ARDS機(jī)械通氣患者的容量反應(yīng)性。
[Abstract]:Objective: to evaluate the predictive value of controlled pulmonary dilatation (SI) in patients with acute respiratory distress syndrome (acute respiratory distress syndrome,ARDS) mechanical ventilation. Methods: from March to December 2016, ARDS patients undergoing mechanical ventilation in the Department of severe Medicine, Danyang people's Hospital were included in the study. The hemodynamic changes before and after SI were monitored. 15 min rehydration test (FC), was divided into volume reactive group (FR group, 螖 CI 鈮，

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