急性呼吸窘迫綜合征( ARDS) 柏林定義指出: ARDS 以急性起病, 胸部X 線片示雙肺彌漫性滲出性改變, 無左房高壓的證據, 氧合指數≤300 mm Hg 為臨床特征, 發病率及病死率高。幾乎所有的 ARDS患者都需要機械通氣治療, 但是傳統的通氣模式及參數可能導致呼吸機相關性肺損傷 (VILI) , 主要包括氣壓傷, 容積傷和萎陷傷等。ARDS Network 的研究顯示: 與大潮氣量( 12 mL/ kg) 合并低呼氣末正壓 (PEEP) 的通氣方式相比, 小潮氣量( 6 mL/ kg) 合并高呼氣末正壓的肺保護性通氣策略可以擴張陷閉的肺泡, 同時防止正常肺泡過度擴張, 從而降低肺損傷的發生率, 改善通氣和氧合, 降低患者的死亡率。但是, 在實施肺保護性通氣策略的基礎上, 患者可能在較高的通氣壓力下仍然無法達到基本的通氣和氧合目標, 所以死亡率仍然很高。高頻振蕩通氣( HFOV) 以較快的頻率( 成人180 ～600 次/min) 、較低的潮氣量( 等于或略低于解剖死腔量) 和較高的平均氣道壓為特征, 也是一種肺保護性通氣方式, 可作為傳統通氣方式的替代治療, 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.