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[1]赵和萌,李晓娜,黄圆美,等.肺泡死腔分数与急性呼吸窘迫综合征患儿预后分析[J].中华肺部疾病杂志,2021,(05):620-622.[doi:10.3877/cma.j.issn.1674-6902.2021.05.019]
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肺泡死腔分数与急性呼吸窘迫综合征患儿预后分析(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2021年05期
页码:
620-622
栏目:
临床研究
出版日期:
2021-10-20

文章信息/Info

Title:
-
作者:
赵和萌; 李晓娜; 黄圆美; 周进进; 王 娟
222002 江苏,连云港市第一人民医院儿内科
Author(s):
-
关键词:
肺泡死腔分数;  急性呼吸窘迫综合征;  患儿;  预后
Keywords:
-
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2021.05.019
摘要:
目的 分析肺泡死腔分数(ADSF)与急性呼吸窘迫综合征(ARDS)患儿预后的相关性。方法 回顾性分析2018年2月至2021年2月我院收治的43例ARDS患儿的临床资料,根据患儿的氧合指数(PaO2/FiO2)将患儿分为轻中度组(4≤PaO2/FiO2<16)和重度组(PaO2/FiO2≥16),随访28 d,依据轻中度组和重度组氧合指数(P/F值)、ADSF,比较死亡组和存活组P/F值、ADSF,死亡组和存活组患儿在不同时间段的ADSF,比较两组患儿在不同时间段的ADSF,评估ADSF、P/F值对ARDS患儿死亡的预测。结果 43例ARDS患儿,PaO2/FiO2轻中度组(4≤PaO2/FiO2<16)23例和重度组(PaO2/FiO2≥16)20例,轻中度组ADSF均比重度组低(P<0.05),轻中度组P/F值均比重度组高(P<0.05); 随访28 d,死亡组ADSF均比重度组高(P<0.05),死亡组P/F值比存活组低(P<0.05); 死亡组在0～<24 h、24～<48 h、48～72 h时间段内ADSF均比存活组高(P<0.05); 重度组在0～<24 h、24～<48 h、48～72 h时间段内ADSF均比轻中度组高(P<0.05); ADSF预测ARDS患儿死亡的最佳截断点为0.36,曲线下面积(AUC)为0.742(P<0.05)。结论 ADSF与ARDS患儿病情严重程度有关,且ADSF预测ARDS患儿病情具有临床意义。
Abstract:
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参考文献/References:

1 马李杰, 李王平, 金发光. 急性肺损伤/急性呼吸窘迫综合征发病机制的研究进展[J/CD]. 中华肺部疾病杂志(电子版), 2013, 6(1): 65-68.
2 刘 涛, 任成山. 炎症介质在急性肺损伤/急性呼吸窘迫综合征发病机制中的作用[J/CD]. 中华肺部疾病杂志(电子版), 2013, 6(3): 265-269.
3 施 卉, 任成山. 急性肺损伤/急性呼吸窘迫综合征基础及临床研究进展[J/CD]. 中华肺部疾病杂志(电子版), 2013, 6(4): 350-355.
4 Guerin C, Albert RK, Beitler J, et al. Prone position in ARDS patients: why, when, how and for whom[J]. Intensive Care Med, 2020, 46(12): 2385-2396.
5 Tzotzos SJ, Fischer B, Fischer H, et al. Incidence of ARDS and outcomes in hospitalized patients with COVID-19: a global literature survey[J]. Crit Care, 2020, 24(1): 516.
6 Villar J, Ferrando C, Martinez D, et al. Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre randomised controlled trial[J]. Lancet Respir Med, 2020, 8(3): 267-276.
7 Pancera S, Galeri S, Porta R, et al. Feasibility and efficacy of the pulmonary rehabilitation program in a rehabilitation center: CASE REPORT OF A YOUNG PATIENT DEVELOPING SEVERE COVID-19 ACUTE RESPIRATORY DISTRESS SYNDROME[J]. J Cardiopulm Rehabil Prev, 2020, 40(4): 205-208.
8 Beda A, Winkler T, Wellman TJ, et al. Physiological mechanism and spatial distribution of increased alveolar dead-space in early ARDS: An experimental study[J]. Acta Anaesthesiol Scand, 2021, 65(1): 100-108.
9 中华医学会重症医学分会. 急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南(2006)[J]. 中国实用外科杂志, 2007, 28(1): 19-28.
10 Huppert LA, Matthay MA, Ware LB. Pathogenesis of acute respiratory distress syndrome[J]. Semin Respir Crit Care Med, 2019, 40(1): 31-39.
11 Gattinoni L, Busana M, Giosa L, et al. Prone positioning in acute respiratory distress syndrome[J]. Semin Respir Crit Care Med, 2019, 40(1): 94-100.
12 Coudroy R, Chen L, Pham T, et al. Acute respiratory distress syndrome:Respiratory monitoring and pulmonary physiology[J]. Semin Respir Crit Care Med, 2019, 40(1): 66-80.
13 Caudron M, Holt T, Cuvelier G, et al. Pulmonary thromboses in pediatric acute respiratory distress syndrome[J]. Respir Care, 2019, 64(2): 209-216.
14 Sklar MC, Patel BK, Beitler JR, et al. Optimal ventilator strategies in acute respiratory distress syndrome[J]. Semin Respir Crit Care Med, 2019, 40(1): 81-93.
15 Chen L, Del SL, Grieco DL, et al. Potential for lung recruitment estimated by the recruitment-to-inflation ratio in acute respiratory distress syndrome. A clinical trial[J]. Am J Respir Crit Care Med, 2020, 201(2): 178-187.
16 Candan SA, Elibol N, Abdullahi A. Consideration of prevention and management of long-term consequences of post-acute respiratory distress syndrome in patients with COVID-19[J]. Physiother Theory Pract, 2020, 36(6): 663-668.
17 Williams GW, Berg NK, Reskallah A, et al. Acute respiratory distress syndrome[J]. Anesthesiology, 2021, 134(2): 270-282.
18 王 灵, 王万灵, 刘雪晖. 肺泡动脉氧分压差用于急性呼吸窘迫综合征的分层诊断及指导治疗价值[J]. 重庆医学, 2020, 49(5): 750-753.
19 Matthay MA, Arabi YM, Siegel ER, et al. Phenotypes and personalized medicine in the acute respiratory distress syndrome[J]. Intensive Care Med, 2020, 46(12): 2136-2152.
20 闫海燕, 杨云华, 杨云秀, 等. ARDS患者肺泡动脉氧分压差与死腔分数检测在病情判断和短期预后评估中的应用价值[J]. 现代检验医学杂志, 2021, 36(2): 132-135,164.
21 姚小静, 刘春峰. 肺泡死腔分数与急性呼吸窘迫综合征患儿病情及预后关系的研究[J]. 中国小儿急救医学, 2018, 25(11): 829-833,838.
22 Munshi L, Walkey A, Goligher E, et al. Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis[J]. Lancet Respir Med, 2019, 7(2): 163-172.

备注/Memo

备注/Memo:
基金项目: 江苏省自然科学基金资助项目(BK20191211)
通信作者: 王 娟, Email: hg65fdk@163.com
更新日期/Last Update: 2021-10-20