急性呼吸窘迫综合征( ARDS) 柏林定义指出: ARDS 以急性起病, 胸部X 线片示双肺弥漫性渗出性改变, 无左房高压的证据, 氧合指数≤300 mm Hg 为临床特征, 发病率及病死率高。几乎所有的 ARDS患者都需要机械通气治疗, 但是传统的通气模式及参数可能导致呼吸机相关性肺损伤 (VILI) , 主要包括气压伤, 容积伤和萎陷伤等。ARDS Network 的研究显示: 与大潮气量( 12 mL/ kg) 合并低呼气末正压 (PEEP) 的通气方式相比, 小潮气量( 6 mL/ kg) 合并高呼气末正压的肺保护性通气策略可以扩张陷闭的肺泡, 同时防止正常肺泡过度扩张, 从而降低肺损伤的发生率, 改善通气和氧合, 降低患者的死亡率。但是, 在实施肺保护性通气策略的基础上, 患者可能在较高的通气压力下仍然无法达到基本的通气和氧合目标, 所以死亡率仍然很高。高频振荡通气( HFOV) 以较快的频率( 成人180 ～600 次/min) 、较低的潮气量( 等于或略低于解剖死腔量) 和较高的平均气道压为特征, 也是一种肺保护性通气方式, 可作为传统通气方式的替代治疗, 降低ARDS患者的死亡率。
Decellularized extracellular matrix (dECM) has been widely used as a scaffold for regenerative medicine due to its high biomimetic and excellent biocompatibility. As a functional polymer material with high water content and controlled fluidity, hydrogel is very promising for some minimally invasive surgery in clinical practice. In recent years, with the rapid development of hydrogel theory and technology, dECM hydrogel has gradually become a research hotspot in the field of regenerative medicine. In this paper, the related researches in recent years are reviewed regarding the preparation of dECM hydrogel and its preclinical application. The future clinical use is also prospected.