CAJ | 학술논문

目的：探讨使用双水平通气模式（BILEVEL）进行改良叹气法肺复张（RM）与压力控制法（PCV）肺复张应用于外源性急性呼吸窘迫综合征（ARDS）病人的效果。方法将外源性急性呼吸窘迫综合征病人50例，按照交叉设计的方法在不同时段分别应用BILEVEL ，PCV两种肺复张，记录肺复张前后病人平均动脉压，中心静脉压，氧合指数，肺静态顺应性等指标，进行对照研究。结果两组患者RM后短时间内氧合指数和肺静态顺应性指标显著改善，PCV组30 min、1 h的增加幅度较BILEVEL组明显减少，2 h时两组数据之间无明显差别。RM 后病人短时间内均有心率增快，CVP上升，MAP下降，PCV组变化幅度更大，30 min后两组数据之间无明显差别。结论对于肺外源性 ARDS行RM ，BILEVEL肺复张对肺顺应性和氧合改善效果好，对血流动力学影响较小。
목적：탐토사용쌍수평통기모식（BILEVEL）진행개량우기법폐복장（RM）여압력공제법（PCV）폐복장응용우외원성급성호흡군박종합정（ARDS）병인적효과。방법장외원성급성호흡군박종합정병인50례，안조교차설계적방법재불동시단분별응용BILEVEL ，PCV량충폐복장，기록폐복장전후병인평균동맥압，중심정맥압，양합지수，폐정태순응성등지표，진행대조연구。결과량조환자RM후단시간내양합지수화폐정태순응성지표현저개선，PCV조30 min、1 h적증가폭도교BILEVEL조명현감소，2 h시량조수거지간무명현차별。RM 후병인단시간내균유심솔증쾌，CVP상승，MAP하강，PCV조변화폭도경대，30 min후량조수거지간무명현차별。결론대우폐외원성 ARDS행RM ，BILEVEL폐복장대폐순응성화양합개선효과호，대혈류동역학영향교소。
Objective To study the clinical effects of BILEVEL modified type and pressure control ventilation (PCV ) in the therapy of exogenous ARDS .Methods 50 cases of patients with exogenous ARDS were undergoed two RM at different times , respectively according to crossover design method BILEVEL modified type ,pressure control ventilation (PCV) .Mean arterial blood pressure(MAP) ,central venous pressure(CVP) ,oxygenation index ,lung compliance were recorded before and after RM and analysised .Results Oxygenation index and lung compliance were improved obviously in a short time after RM ,30min and 1 hour ungraded extent of PCV group were less than BILEVEL modified type groups obviously ,after two hours ,dates of the two groups were similar .After RM ,heart rate and CVP were increased ,MAP was decreased in a short time ,changes of PCV group were larger than BILEVEL modified type group ,after 30 min ,dates of two groups were similar .Conclusions For the patients with exogenous ARDS undergone RM ,BILEVEL modified type method was effective on improving oxygenation index and lung compliance ,and had fewer effects on hemodynamics .