Clinical Comparison Of Pulmonary Protective Ventilation Strategy In The Treatment Of Pulmonary And Pulmonary Exogenous Acute Respiratory Distress Syndrome

Objective To take in the lungs and pulmonary lung protective ventilation strategy of exogenous acute respiratory distress syndrome in patients with respiratory mechanics, blood gas analysis, computer time and average hospitalization days of clinical difference comparative analysis.Methods Choose since January 1, 2012 to June 30, 2014 in our hospital intensive medicine, respiratory medicine, thoracic surgery hospital treatment of 86 patients with acute respiratory distress syndrome, and is based on the primary or secondary is divided into two groups: endogenous pulmonary acute respiratory distress syndrome group(group ARDSp) and pulmonary exogenous acute respiratory distress syndrome group(ARDSexp group). 49 cases of 86 cases of patients are men, the other 37 cases are women,Including ARDSp group of 40 cases of patients; Of severe pneumonia in 11 cases, pulmonary contusion; 29 cases of 46 patients with ARDSexp group, including 12 cases of severe infection, acute pancreatitis in 2 cases, 32 cases of multiple trauma. Two groups of patients in the general clinical data including age, gender composition ratio on the comparison of difference of no statistical significance(P > 0.05). Lung protective ventilation strategy should be used in all patients treated, on two groups of patients with the breathing machine on respiratory mechanics, blood gas index, the average time and hospital stay comparative analysis.Results(1) 40 cases of patients in the ARDSp group and 46 cases in group ARDSexp were treated 0 minutes to start the Ppeak, Pplat, Pmean value of the difference was not statistically significant;(2) 40 cases of ARDSp patients in the treatment group after 30 minutes, 1 hours, 3 hours, 12 hours, 24 hours of Ppeak, Pplat, Pmean were decreased, the difference was statistically significant;(3) 46 cases of ARDSexp patients in the treatment group after 30 minutes, 1 hours, 3 hours, 12 hours, 24 hours of Ppeak, Pplat, Pmean were decreased, the difference was statistically significant;(4) 40 patients with ARDSp group and 46 patients with ARDSexp group after treatment of 30 minutes, 1 hour, 3 hours, 12 hours, 24 hours of Ppeak, Pplat, Pmean are compared, and two 30 minutes when ARDSp group of patients with Ppeak, Pplat, Pmean values were higher than in 46 patients with ARDSexp group values, differences between the two groups was statistically significant(P < 0.05). 1 hour, 3 hours, 12 hours, 24 hours of two groups of patients Ppeak, Pplat, Pmean value difference was not statistically significant;(5) 40 patients with ARDSp group and 46 patients with ARDSexp group blood gas analysis in front of the computer, Sa O2, Pa O2, Pa O2/Fi O2 differences did not have statistical significance;(6) 40 patients with ARDSp group computer after 30 minutes, 1 hour, 3 hours, 12 hours, 24 hours of blood gas analysis, Sa O2, Pa O2, Pa O2/ Fi O2 compared with before the computer two respectively, significant difference(P < 0.01), and extended over time, the increase of difference;(7) In 46 patients with ARDSexp group computer after 30 minutes, 1 hour, 3 hours, 12 hours, 24 hours of blood gas analysis, Sa O2, Pa O2, Pa O2/ Fi O2 compared with before the computer two respectively, significant difference(P < 0.01), and extended over time, the increase of difference;(8) 40 patients with ARDSp group and 46 patients with ARDSexp group 30 minutes, 1 hour, 3 hours, 12 hours, 24 hours a day, Sa O2, Pa O2, Pa O2/ Fi O2 are compared, and two 30 minutes when ARDSp patients Sa O2, Pa O2, Pa O2/ Fi O2 values are lower than in 46 patients with ARDSexp group values, differences between the two groups was statistically significant(P < 0.05). 1 hour, 3 hours, 12 hours, 24 hours of two groups of patients, Sa O2, Pa O2, Pa O2/ Fi O2 value difference was not statistically significant(P < 0.05);(9) 40 cases of ARDSp patients and 46 cases of the total time of using ventilator patients in the ARDSexp group the difference was not statistically significant(P > 0.05);(10)In 40 cases of group ARDSp patients and 46 cases of hospitalized patients in the ARDSexp group the difference were not statistically significant(P > 0.05)。Conclusions Domestic research on pulmonary and extrapulmonary ARDS mechanical ventilation for less, mostly for the study of animal experiment. The study of ARDS in patients with lung protective strategy for treatment, that can improve the oxygenation, improve lung function, improve the success rate, improve the prognosis of patients, and further suggest that lung protective strategy for extra pulmonary acute respiratory distress syndrome treatment effect is obviously better than that of endogenous pulmonary ARDS syndrome. But there was no difference in the use of the ventilator time and hospitalization time.