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目的探讨保护性机械通气在烧伤合并重度吸入性损伤救治中的重要性。方法对烧伤合并重度吸入性损伤的12例患者采用低潮气量、低PEEP和“允许性高碳酸血症”的保护性通气模式。分别在机械通气前和通气后2小时、1、3、7天行动脉血气分析,并测定心率、中心静脉压变化,以及胸部X线检查。结果本组行机械通气后,其氧合指征PaO2和SPO2明显改善,在“允许性高碳酸血症”状态下,患者心率、中心静脉压变化不明显。治疗期间,除1例肺大泡患者出现气胸外,未见其他并发症发生。结论对烧伤合并重度吸入性损伤患者采用保护性机械通气治疗效果理想,并可有效预防呼吸机相关性肺损伤的发生。
Objective To explore the importance of protective mechanical ventilation in the treatment of severe combined inhalation injury. Methods Twelve patients with burn injury complicated with severe inhalation injury were given low ventilation, low PEEP and “protective hypercapnia” protective ventilation mode. Arterial blood gas analysis was performed before mechanical ventilation and 2 hours, 1, 3, and 7 days after ventilation, and heart rate, changes of central venous pressure, and chest X-ray were measured. Results This group of mechanical ventilation, the oxygenation signs PaO2 and SPO2 significantly improved in the “allowable hypercapnia” state, the patient’s heart rate, central venous pressure did not change significantly. During treatment, no other complication occurred except for pneumothorax in 1 patient with bullae. Conclusion The protective mechanical ventilation in patients with severe burn injury and burn injury is effective and can effectively prevent the occurrence of ventilator-associated lung injury.