临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2014年
5期
543-545,546
,共4页
呼吸窘迫综合征,成人%呼吸,人工%肺顺应性%血流动力学
呼吸窘迫綜閤徵,成人%呼吸,人工%肺順應性%血流動力學
호흡군박종합정,성인%호흡,인공%폐순응성%혈류동역학
respiratory distress syndrome,adult%respiration,artificial%lung compliance%hemodynamics
目的：探讨双水平正压通气+压力支持通气模式(BiPAP+PSV)改良叹气法在急性呼吸窘迫综合征患者(ARDS)中的临床应用效果。方法将本院收治的36例 ARDS 患者随机分为试验组和对照组，试验组患者给予BiPAP+PSV 改良叹气法通气治疗，对照组患者给予压力支持法(PSV)通气治疗。比较两组患者肺复张前后氧合指数[氧分压/吸入气体氧含量(PaO 2/FiO 2)]、静态肺顺应性(Cstat)及心率(HR)、中心静脉压(CVP)、平均动脉压(MAP)等血流动力学指标。结果复张前、复张后30分钟、60分钟两组 PaO 2/FiO 2、Cstat 差异无统计学意义(P >0.05)，复张后120分钟试验组 PaO 2/FiO 2、Cstat 显著高于对照组(P <0.05)；试验组患者复张后即刻 HR、CVP、MAP 即开始改善，复张后10分钟恢复原有水平，对照组复张后20分钟才恢复到原有水平。结论与 PSV 相比， BiPAP+PSV 改良叹气法对于 ARDS 患者复张效果确切，能够显著改善氧合与肺顺应性，且对血流动力学影响较小，值得临床推广应用。
目的：探討雙水平正壓通氣+壓力支持通氣模式(BiPAP+PSV)改良歎氣法在急性呼吸窘迫綜閤徵患者(ARDS)中的臨床應用效果。方法將本院收治的36例 ARDS 患者隨機分為試驗組和對照組，試驗組患者給予BiPAP+PSV 改良歎氣法通氣治療，對照組患者給予壓力支持法(PSV)通氣治療。比較兩組患者肺複張前後氧閤指數[氧分壓/吸入氣體氧含量(PaO 2/FiO 2)]、靜態肺順應性(Cstat)及心率(HR)、中心靜脈壓(CVP)、平均動脈壓(MAP)等血流動力學指標。結果複張前、複張後30分鐘、60分鐘兩組 PaO 2/FiO 2、Cstat 差異無統計學意義(P >0.05)，複張後120分鐘試驗組 PaO 2/FiO 2、Cstat 顯著高于對照組(P <0.05)；試驗組患者複張後即刻 HR、CVP、MAP 即開始改善，複張後10分鐘恢複原有水平，對照組複張後20分鐘纔恢複到原有水平。結論與 PSV 相比， BiPAP+PSV 改良歎氣法對于 ARDS 患者複張效果確切，能夠顯著改善氧閤與肺順應性，且對血流動力學影響較小，值得臨床推廣應用。
목적：탐토쌍수평정압통기+압력지지통기모식(BiPAP+PSV)개량우기법재급성호흡군박종합정환자(ARDS)중적림상응용효과。방법장본원수치적36례 ARDS 환자수궤분위시험조화대조조，시험조환자급여BiPAP+PSV 개량우기법통기치료，대조조환자급여압력지지법(PSV)통기치료。비교량조환자폐복장전후양합지수[양분압/흡입기체양함량(PaO 2/FiO 2)]、정태폐순응성(Cstat)급심솔(HR)、중심정맥압(CVP)、평균동맥압(MAP)등혈류동역학지표。결과복장전、복장후30분종、60분종량조 PaO 2/FiO 2、Cstat 차이무통계학의의(P >0.05)，복장후120분종시험조 PaO 2/FiO 2、Cstat 현저고우대조조(P <0.05)；시험조환자복장후즉각 HR、CVP、MAP 즉개시개선，복장후10분종회복원유수평，대조조복장후20분종재회복도원유수평。결론여 PSV 상비， BiPAP+PSV 개량우기법대우 ARDS 환자복장효과학절，능구현저개선양합여폐순응성，차대혈류동역학영향교소，치득림상추엄응용。
Objective To investigate the effect of bi-level positive airway pressure(BiPAP)+ pressure support ventilation mode(BiPAP+PSV)improved sigh method in patients with acute respiratory distress syndrome(ARDS). Methods Thirty-six ARDS patients admitted to our hospital were randomly divided into experimental group and control group.The patients of experimental group were treated with(BiPAP+PSV)improved sigh method,and those of control group were given pressure control act(PSV)ventilation.The oxygenation index(PaO 2/FiO 2 ),static lung compliance(Cstat)and heart rate(HR),central venous pressure(CVP),mean arterial pressure(MAP)of two groups were compared before and after reexpansion.Results There were no significant difference in reexpansion before and 30 min,60 min after reexpansion in PaO 2/FiO 2 ,Cstat (P > 0.05 );PaO 2/FiO 2 ,Cstat of experimental group were significantly higher than those of control group 120 min after reexpansion(P <0.05);HR,CVP,MAP of experiment began to improve immediately after reexpansion and the indexes restored the original level 10 min after reexpansion, while those of control group restored to the original level 20 min after reexpansion.Conclusion Compared with PCV, BiPAP+PSV improved sigh method has exact effect for ARDS patients in reexpansion,which can significantly improve oxygenation and lung compliance,and the method has less impact on hemodynamics,and it is worth clinical application.
