内科

目的观察不同液体管理策略对急性肺损伤（ALI）患者肺动态顺应性、氧合指数的影响，探讨ALI患者液体管理策略。方法选择2007年1月～2010年2月我院重症监护病房（ICU）收治的45例ALI病例，随机分为限制性液体管理组和非限制性液体管理组，根据中心静脉压（CVP）水平进行液体管理，临床观察15 d。比较两组患者治疗前后肺动态顺应性、氧合指数及使用呼吸机时间。结果治疗第3天，限制性液体管理组较非限制性液体管理组患者的肺动态顺应性及氧合指数上升（P＜0.05），15 d的呼吸机使用时间缩短（P＜0.05）。结论限制性液体管理治疗ALI有助于改善患者的肺动态顺应性、氧合指数，有利于缩短呼吸机的使用时间。

ObjectiveTo observe the influence of different fluid management strategies in lung dynamic compliance,oxygenation index of acute lung injury(ALI) patients,and to explore the optimal fluid management strategy for patients with ALI.Methods45 ALI patients from 2007 January to 2010 February in intensive care unit (ICU) of our hospital were included in the study,randomized into restrictive fluid management groups and non-restrictive fluid management group according to the central venous pressure (CVP),observed for 15 days.Before and after treatment,lung dynamic compliance,oxygenation index and the time of ventilator were compared between the two groups.ResultsAfter 3 days of treatment,lung dynamic compliance and oxygenation index got higher in restrictive fluid management group compared to non-restrictive fluid management group(P＜0.05),and the time of using ventilator shortened(P＜0.05).ConclusionRestrictive fluid management strategy is helpful to improve lung dynamic compliance,oxygenation index and shorten the time of using ventilator.

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