不同通气模式在ARDS病人中应用效果及预后分析

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[关键词] 呼吸窘迫综合征;呼吸，人工;血流动力学;预后;影响因素分析 [中图分类号] ; [文献标志码] [文章编号] （ ） doi：10.1712/ms.2096-532.2025.61.063

[Abstract] Objective Toinvestigatetheaplicationefectofdiferentventilationmodesinpatientswithacuterespiratory distres syndrome（ARDS）andtheirimpactonprognosis. Methods Atotalof162ARDSpatientswhoatendedSecondPeople’sHospitalofLuoheCityfromJanuary2020toFebruary2023wereenroledandrandomlydividedintoobservationgroupand controlgroup，with81patientsineachgroup.Thepatientsintheobservationgroupreceivedpresure-regulatedvolumecontrol ventilation（PRVC），whilethoseinthecontrolgroupreceivedsynchronizedintermitentmandatoryventilation （SIMV）.Related indicatorswerecomparedbetwenthetwogroups.Acordingtothesurvivalstatusofpatientsonday21afterenrolment，they weredividedintosurvivalgroupanddeathgroup，andtheLogisticregresionanalysiswasusedtoinvestigatetheasociationbetwenventilationmodeandprognosis. Results Afterintervention，bothgroupshadasignificantincreaseinarterialpartialpressureofoxygen ⋅t=34.412，44.908，P<0.05） ）andasignificantreductioninarterialpartialpresureofcarbondioxide PaCO2 ） ⟨t= 16.116，8.430，P<0.05） ），andcomparedwiththecontrolgroup，theobservationgrouphadasignificantlylower PaCO2 afterintervention （t=7.908，P<0.05） ）.Comparedwiththecontrolgroup，theobservationgrouphadasignificantlyshorterventilationtime andsignificantlylowernumbersofsputumaspirationproceduresandventilatoralarms （t=7.183-9.419，P<0.05） ）.Anincreasein age ⟨OR=1.199，P<0.05） ），anincreaseinAcutePhysiologyandChronicHealthEvaluation I score ⟨OR=1.813，P<0.05⟩ ），and areductioninoxygenationindex ）increasedtheriskofdeath，andcomparedwithSIMV，PRVCreducedthe riskofdeath ⟨OR=0.162，P<0.05） ）. Conclusion PRVCcanincreaseventilationeficiency，improverespiratoryparameters， andreducetheriskofdeathinARDSpatients.

[Keywords] respiratorydistres syndrome;respiration，artificial;hemodynamics;prognosis;rotcauseanalysis

急性呼吸窘迫综合征（ARDS）是一种因肺泡和微血管通透性障碍导致的严重炎症反应，表现为急性呼吸困难、低氧血症和肺部浸润，常伴发热、心率增快、高碳酸血症等，易引发多器官功能障碍综合征和死亡[1-2]。（剩余5464字）