中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2010年
1期
74-77
,共4页
黄河%李寅环%岑燕遗%刘晓青%陈荣昌
黃河%李寅環%岑燕遺%劉曉青%陳榮昌
황하%리인배%잠연유%류효청%진영창
平均吸气压力%张力时间指数%呼吸努力%无创性评估%脱机
平均吸氣壓力%張力時間指數%呼吸努力%無創性評估%脫機
평균흡기압력%장력시간지수%호흡노력%무창성평고%탈궤
Mean inspiratory pressure(Pi)%Tension-time index(TTI)%Respiratory effort%Noninvasive as-sessment%Weaning
目的 本研究拟探讨以公式Pi=5×P0.1×Ti为依据,通过测定几腔阻断压(P0.1)以计算预备脱机患者中平均吸气压(Pi)以及无创张力时间指数(TTIi)来无创性评估患者呼吸努力和呼吸负荷/能力比率的可能性及其效率.方法 本研究所有试验对象均来自广州呼吸疾病研究所英东重症监护中心并获得广州医学院第一附属医院临床试验伦理委员会的批准,受试对象知情同意.12例预备脱机患者,COPD 9例,ARDS 2例,重症哮喘1例,通过插入食道囊管监测食道压力(PesoM),经胸壁弹性压的矫正后得到矫正的食道压力(Peso).以常规方法测定P 0.1和气道压力曲线上的最大吸气压(MIPaw)以及食道压力曲线上的最大吸气压(NIPeso).通过方程Pi=5×P0.1×Ti计算Pi;以Pi和MIPaw计算Tni,以Peso和MIPeso计算食道张力时间指数(TTIeso),分别比较Pi与Peso以及TTIi与TTIeso的大小,并分析无创性指标与相应有创性指标之间的相关性与一致性.结果 Pi与Peso之间以及TTIi与TTIeso之间差异无统计学意义(P>0.05),其相关系数分别为0.974和0.957.一致性分析中,Pi与Peso之间以及TTIi与TTIeso之间的平均差值分别小于(Peso+Pi)/2和(TTI+TTIeso)/2中的最小值.结论 本研究表明,Pi与Peso之间以及TTIi与TTIeso之间具有良好的相关性与一致性,这两个无创性指标可用于预备脱机患者呼吸努力以及呼吸负荷/能力比率的无创性评估.
目的 本研究擬探討以公式Pi=5×P0.1×Ti為依據,通過測定幾腔阻斷壓(P0.1)以計算預備脫機患者中平均吸氣壓(Pi)以及無創張力時間指數(TTIi)來無創性評估患者呼吸努力和呼吸負荷/能力比率的可能性及其效率.方法 本研究所有試驗對象均來自廣州呼吸疾病研究所英東重癥鑑護中心併穫得廣州醫學院第一附屬醫院臨床試驗倫理委員會的批準,受試對象知情同意.12例預備脫機患者,COPD 9例,ARDS 2例,重癥哮喘1例,通過插入食道囊管鑑測食道壓力(PesoM),經胸壁彈性壓的矯正後得到矯正的食道壓力(Peso).以常規方法測定P 0.1和氣道壓力麯線上的最大吸氣壓(MIPaw)以及食道壓力麯線上的最大吸氣壓(NIPeso).通過方程Pi=5×P0.1×Ti計算Pi;以Pi和MIPaw計算Tni,以Peso和MIPeso計算食道張力時間指數(TTIeso),分彆比較Pi與Peso以及TTIi與TTIeso的大小,併分析無創性指標與相應有創性指標之間的相關性與一緻性.結果 Pi與Peso之間以及TTIi與TTIeso之間差異無統計學意義(P>0.05),其相關繫數分彆為0.974和0.957.一緻性分析中,Pi與Peso之間以及TTIi與TTIeso之間的平均差值分彆小于(Peso+Pi)/2和(TTI+TTIeso)/2中的最小值.結論 本研究錶明,Pi與Peso之間以及TTIi與TTIeso之間具有良好的相關性與一緻性,這兩箇無創性指標可用于預備脫機患者呼吸努力以及呼吸負荷/能力比率的無創性評估.
목적 본연구의탐토이공식Pi=5×P0.1×Ti위의거,통과측정궤강조단압(P0.1)이계산예비탈궤환자중평균흡기압(Pi)이급무창장력시간지수(TTIi)래무창성평고환자호흡노력화호흡부하/능력비솔적가능성급기효솔.방법 본연구소유시험대상균래자엄주호흡질병연구소영동중증감호중심병획득엄주의학원제일부속의원림상시험윤리위원회적비준,수시대상지정동의.12례예비탈궤환자,COPD 9례,ARDS 2례,중증효천1례,통과삽입식도낭관감측식도압력(PesoM),경흉벽탄성압적교정후득도교정적식도압력(Peso).이상규방법측정P 0.1화기도압력곡선상적최대흡기압(MIPaw)이급식도압력곡선상적최대흡기압(NIPeso).통과방정Pi=5×P0.1×Ti계산Pi;이Pi화MIPaw계산Tni,이Peso화MIPeso계산식도장력시간지수(TTIeso),분별비교Pi여Peso이급TTIi여TTIeso적대소,병분석무창성지표여상응유창성지표지간적상관성여일치성.결과 Pi여Peso지간이급TTIi여TTIeso지간차이무통계학의의(P>0.05),기상관계수분별위0.974화0.957.일치성분석중,Pi여Peso지간이급TTIi여TTIeso지간적평균차치분별소우(Peso+Pi)/2화(TTI+TTIeso)/2중적최소치.결론 본연구표명,Pi여Peso지간이급TTIi여TTIeso지간구유량호적상관성여일치성,저량개무창성지표가용우예비탈궤환자호흡노력이급호흡부하/능력비솔적무창성평고.
Objective To investigate the feasibility and efficiency of monitoring noninvasive respiratory effort and respiratory load-capacity ratio in patients undergoing weaning from mechanical ventilation by mean inspiratory pressure(Pi) which were calculated on the basis of the formula, Pi = 5 × P 0.1 × Ti, as well as the noninvasire tension index calculated from Pi(TTIi). Method Totally 12 patients undergoing weaning from mechanical ventilation were enrolled in the study and their underlying diseases included COPD( n = 9), ARDS( n = 2) and status asthmaticus(n = 1) respectively. Esophageal pressure(PesoM) was monitored via the insertion of esophageal balloon and corrected esophageal pressure(Peso) was acquired by subtracting elastic pressure of chest wall from PesoM. P 0.1, Maximal inspiratory pressure on esophageal pressure curve(MIPeso) and on airway pressure curve(MIPaw) was measured with conventional technique. Pi was calculated on Pi = 5 × P 0.1 × Ti. Pi and MIPaw were used to calculate the noninvasive tension-time index TTIi, whereas Peso and MIPeso were used to calculate the invasive counterpart TTIeso. Comparisons, Correlation and Bland-Altman agreement analysis were made between P0.1 and Peso as well as between TIIi and TTIeso. Results There were no significant differences between Pi and Peso as well as between TTIi and TTIeso(P > 0.05) ,and the correlation coefficients were 0.974 and 0.957 respectively. In the agreement analysis, the mean difference between Pi and Peso, and between TTIi and TTIeso were lower than the minimal values of(Peso + PiSB )/2 and of(TIIi + TTIeso)/2, respectively. Conclusions There is a good correlation between Pi and Peso as well as between TTIi and TTIeso, in which Pi is calculated calculated from P 0.1 and in turn the TTIi is calculated from Pi. The noninvasive indices including Pi and TTIi can be used to monitor respiratory effort and respiratory load-capacity in patients undergoing weaning from mechanical ventilation.
