| 摘要: |
| 目的 探讨肺部超声肺通气评分在评估急性呼吸窘迫综合征（ARDS）患者血管外肺水方面的价值。方法 回顾性收集2015年6月至2017年2月上海中医药大学附属第七人民医院重症医学科收治的7 d内治疗好转的32例ARDS患者的临床资料，记录患者入科时及7 d后的肺通气总评分、血管外肺水指数（EVLWI）、氧合指数（PaO2/FiO2）、中心静脉压（CVP）。研究肺通气总评分与急性生理和慢性健康状况评估Ⅱ（APACHE Ⅱ）评分、EVLWI、氧合指数、CVP的相关性。结果 经入科后治疗好转的ARDS患者与入科时比较，入科7 d后APACHEⅡ评分、肺通气总评分、EVLWI均下降，氧合指数升高，差异均有统计学意义（P均<0.01）。肺通气总评分与APACHEⅡ评分、EVLWI、CVP呈正相关（r=0.95、0.95、0.64，P均<0.01），与氧合指数呈负相关（r=-0.94，P<0.01）。结论 肺部超声肺通气评分能有效评估ARDS患者血管外肺水，可作为ARDS患者血管外肺水监测手段中除脉波指示剂连续心输出量（PiCCO）以外的有效补充手段。 |
| 关键词: 肺疾病 肺通气评分 血管外肺水 急性呼吸窘迫综合征 |
| DOI：10.16781/j.0258-879x.2018.01.0057 |
| 投稿时间：2017-05-01修订日期：2017-09-06 |
| 基金项目:上海市卫生计生系统重要薄弱学科建设项目（2016ZB0201），上海市浦东新区卫生系统重点学科建设项目（PWZxk2017-15）. |
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| Value of pulmonary ventilation score in evaluating extravascular lung water of patients with acute respiratory distress syndrome |
| YAO Yu-long1,2,LEI Ming2,LI Wen-fang1*,LIN Zhao-fen1 |
(1. Department of Emergency, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;
2. Department of Critical Care Medicine, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
*Corresponding author) |
| Abstract: |
| Objective To discuss the value of pulmonary ventilation score in evaluating the extravascular lung water (EVLW) of patients with acute respiratory distress syndrome (ARDS). Methods We retrospectively collected the clinical data of 32 patients with ARDS, who were treated in the Department of Critical Care Medicine of Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine from Jun. 2015 to Feb. 2017 and improved within 7 days. The total pulmonary ventilation score, extravascular lung water index (EVLWI), oxygenation index (PaO2/FiO2), and central venous pressure (CVP) of patients at admission and after treatment for 7 d were recorded. The correlations between total pulmonary ventilation score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, EVLWI, oxygenation index and CVP were analyzed. Results The APACHE Ⅱ score, total pulmonary ventilation score and EVLWI of the ARDS patients after treatment for 7 d were significantly decreased compared with those at admission, and the oxygenation index was significantly increased (all P<0.01). The pulmonary ventilation score was positively correlated with the APACHE Ⅱ score, EVLWI and CVP (r=0.95, 0.95, 0.64; all P<0.01), and was negatively correlated with the oxygenation index (r=-0.94, P<0.01). Conclusion Pulmonary ventilation score can effectively evaluate the EVLW of patients with ARDS, and can be used as an effective supplement for EVLW monitoring in patients with ARDS in addition to pulse indicator continous cadiac output. |
| Key words: pulmonary disease pulmonary ventilation score extravascular lung water acute respiratory distress syndrome |
