有創通氣在重癥嚴重急性呼吸綜合征患者中的應用_《中國循證醫學雜志》

作者：

周立新 , 譽鐵鷗 , 方濱 , 李軼男 , 溫偉標 , 鄒毅成 , 馬明遠 , 毛克江

廣東省佛山市第一人民醫院ICU,佛山,528000;

關鍵詞：

重癥嚴重急性呼吸綜合征機械通氣肺保護隔離防護

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目的　探討有創機械通氣在重癥嚴重急性呼吸綜合征(SARS)中的應用效果.
方法　對2002年11月至2003年4月佛山市第一人民醫院ICU收治的6例重癥SARS患者有創機械通氣的療效和隔離防護的效果進行回顧性分析.
結果　6例重癥SARS患者均成功撤離呼吸機,痊愈出院,無一例死亡;機械通氣撤離時低氧血癥和氧合指數較實施前均明顯改善(P＜0.001),氣道峰壓(P=0.002)和氣道均壓(P=0.004)顯著降低,所需呼吸末正壓水平亦明顯減少(P＜0.001);發生呼吸機相關性肺炎5例;與SIMV通氣相比較,采用PRVC通氣時所用鎮靜劑用量較小,通氣時間較短;無醫務人員、患者和患者家屬發生SARS院內感染.
結論　對重癥SARS患者實施肺保護性通氣策略和有效的隔離防護,能降低死亡率,減少機械通氣時間,減少SARS院內感染.

引用本文： 周立新,譽鐵鷗,方濱,李軼男,溫偉標,鄒毅成,馬明遠,毛克江. 有創通氣在重癥嚴重急性呼吸綜合征患者中的應用. 中國循證醫學雜志, 2004, 04(8): 573-577. doi: 復制

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8.	［5］Namen AM, Ely EW, Tatter SB, Case LD, Lucia MA, Smith A, Landry S, Wilson JA, Glazier SS, Branch CL, Kelly DL,Bowton DL, Haponik EF. Predictors of successful extubation in eurosurgical patients[J]. Am J Respir Crit Care Med, 2001; 163(3 Pt 1) :658 -664.
9.	［6］Guldager H, Nielsen SL, Carl P, Soerensen MB. A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure [J ]. Crit Care (Lond) ,1997 ;1 (2) :75 -77.
10.	［7］Mancini M, Zavala E, Mancebo J, Fernandez C, Barbera JA,Rossi A, Roca J, Rodriguez-Roisin R. Mechanisms of pulmonary gas exchange improvement during a protective ventilatory strategy in acute respiratory distress syndrome [J]. Am J Respir Crit Care Med, 2001; 164(8 Pt 1 ) :1 448 - 1 453.
11.	［8］Yin ZB, Zhang FC, Tang XP, Chen WL, Chen YQ, Wang J, Jia WD. Measurement of subsets of blood T lymphocyte in 93patients with severe acute respiratory syndrome[J]. Clin J Tubere Respir Dis, 2003,26(6): 343 -346.
12.	尹志標,張復春,唐小平,陳偉烈,陳燕清,王健,賈衛東.93例傳染性非典型肺炎患者外周血T淋巴細胞亞群變化及臨床意義[J].中華呼吸和結核雜志,2003;26(6):343～346.
13.	［9］Wong KT, Antonio GE, Hui DS, Lee N, Yuen EH, Wu A, Leung CB, Rainer TH, Cameron P, Chung SS, Sung JJ,Ahuja AT. Severe Acute Respiratory Syndrome: Radiographic Appearances and Pattern of Progression in 138 Patients[J]. Radiology, 2003; 228(2):401 -406.

1. ［1］Chinese Medical Association, China Association of Chinese Medicine. The scheme of diagnosis and therapy of severe acute respiratory syndrome (SARS) [J]. Natl Med J China, 2003;19:1731 -1752.
2. 中華醫學會,中華中醫藥學會.傳染性非典型肺炎(嚴重急性呼吸綜合征,SARS)診療方案[J].中華醫學雜志,2003;19 :1 731～1 752.
3. ［2］The General Office of Health Ministry. The clinical diagnosis criterian of severe acute respiratory syndrome (proposed) and the diagnosis criterian of severe infective untypical pneumonia. May 3rd, 2003 Aailable from: URL: http://www. mob gov. cn/zhgl/zt/1200305040087. htm.
4. 衛生部辦公廳.傳染性非典型肺炎臨床診斷標準(試行)和重癥非典型肺炎診斷標準.2003年5月3日Aailable from:URL:http://www. moh. gov. cn/zhgl/zt/1200305040087. htm.
5. ［3］Zhou LX, TanJJ, Wu M, Luo HT, Yu TO, Kang P, Fang B, Li YN, Wen WB, Zou YC. The first case of severe acute respiratory syndrome in Foshan [ J ]. Chin J Tubere Respir Dis,2003, 26(10) :598 -601.
6. 周立新,譚家駒,吳敏,羅紅濤,譽鐵鷗,康萍,方濱,李軼男,溫偉標,鄒毅成.廣東省佛山市嚴重急性呼吸綜合征首例報告[J].中華結核和呼吸雜志,2003,26(10):598～601.
7. ［4］Lu Q, Vieira SR, RichecoeurJ, Puybasset L, Kalfon P, Coriat P, Rouby JJ. A simple automated method for measuring pressure-volume curves during mechanical ventilation. Am J Respir Crit Care Med, 1999; 159: 275 - 282.
8. ［5］Namen AM, Ely EW, Tatter SB, Case LD, Lucia MA, Smith A, Landry S, Wilson JA, Glazier SS, Branch CL, Kelly DL,Bowton DL, Haponik EF. Predictors of successful extubation in eurosurgical patients[J]. Am J Respir Crit Care Med, 2001; 163(3 Pt 1) :658 -664.
9. ［6］Guldager H, Nielsen SL, Carl P, Soerensen MB. A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure [J ]. Crit Care (Lond) ,1997 ;1 (2) :75 -77.
10. ［7］Mancini M, Zavala E, Mancebo J, Fernandez C, Barbera JA,Rossi A, Roca J, Rodriguez-Roisin R. Mechanisms of pulmonary gas exchange improvement during a protective ventilatory strategy in acute respiratory distress syndrome [J]. Am J Respir Crit Care Med, 2001; 164(8 Pt 1 ) :1 448 - 1 453.
11. ［8］Yin ZB, Zhang FC, Tang XP, Chen WL, Chen YQ, Wang J, Jia WD. Measurement of subsets of blood T lymphocyte in 93patients with severe acute respiratory syndrome[J]. Clin J Tubere Respir Dis, 2003,26(6): 343 -346.
12. 尹志標,張復春,唐小平,陳偉烈,陳燕清,王健,賈衛東.93例傳染性非典型肺炎患者外周血T淋巴細胞亞群變化及臨床意義[J].中華呼吸和結核雜志,2003;26(6):343～346.
13. ［9］Wong KT, Antonio GE, Hui DS, Lee N, Yuen EH, Wu A, Leung CB, Rainer TH, Cameron P, Chung SS, Sung JJ,Ahuja AT. Severe Acute Respiratory Syndrome: Radiographic Appearances and Pattern of Progression in 138 Patients[J]. Radiology, 2003; 228(2):401 -406.

《中國循證醫學雜志》

有創通氣在重癥嚴重急性呼吸綜合征患者中的應用

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《中國循證醫學雜志》

有創通氣在重癥嚴重急性呼吸綜合征患者中的應用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料