CAJ | 학술논문

目的：研究机械通气时不同呼气末正压（PEEP）参数对慢性阻塞性肺疾病（COPD）患者肝脏形态、功能及血流动力学的影响。方法采用前瞻性、开放性、自身对照的研究方法，对50例因COPD呼吸衰竭行机械通气的患者，待其病情稳定后，观察在PEEP分别为0、5、10 cmH2O时腹腔压力（IAP）的改变，以及肝脏形态、肝门静脉内径、血流动力学和肝功能的变化。结果随着PEEP值增大，IAP随之增加(P<0.01)；肝脏形态未发生明显变化，门静脉内径无显著改变(P>0.05)，门静脉血流减慢(P<0.05)，肝功能改变差异无统计学意义(P>0.05)。结论机械通气时较高的PEEP值会使IAP升高、门静脉血流减慢，但门静脉内径及肝功能所受影响不明显。
목적：연구궤계통기시불동호기말정압（PEEP）삼수대만성조새성폐질병（COPD）환자간장형태、공능급혈류동역학적영향。방법채용전첨성、개방성、자신대조적연구방법，대50례인COPD호흡쇠갈행궤계통기적환자，대기병정은정후，관찰재PEEP분별위0、5、10 cmH2O시복강압력（IAP）적개변，이급간장형태、간문정맥내경、혈류동역학화간공능적변화。결과수착PEEP치증대，IAP수지증가(P<0.01)；간장형태미발생명현변화，문정맥내경무현저개변(P>0.05)，문정맥혈류감만(P<0.05)，간공능개변차이무통계학의의(P>0.05)。결론궤계통기시교고적PEEP치회사IAP승고、문정맥혈류감만，단문정맥내경급간공능소수영향불명현。
Objective To research the impact of various PEEP parameters of mechanical ventilation on liver mor-phology and function and on hemodynamics. Methods Fifty patients of respiratory failure due to COPD using mechanical ventilation was observed by prospective, exoterical and self-control methods after their condition were stabilized. The varia-tion of abdominal pressure was measured with different PEEP of 0 cmH2O, 5 cmH2O and 10 cmH2O with mechanical ventila-tion, and measured when patients breathe autonomously with tracheostomy tube. The changes of liver morphology, hepatic por-tal vein diameter, hemodynamics and liver function were also measured on above circumstances. Results With PEEP value increases:the abdominal pressure (IAP) rise (P<0.01) while liver morphology, function and hepatic portal did not change markedly evidently (P>0.05). By contrast, blood flow of hepatic portal vein reduced with PEEP increase (P<0.05). Conclu-sion Higher PEEP values on mechanical ventilation will causes abdominal pressure increases and low blood flow of hepatic portal , but not obvious impact on portal vein diameter and liver function.