CAJ | 학술논문

目的利用准静态法描记急性呼吸窘迫综合征(ARDS)患者压力-容积曲线(P-V曲线),分析其呼气支的回归点与呼气末死腔变化的关系.方法采用前瞻性研究方法,选取本院14例接受机械通气的ARDS患者,用准静态法描记P-V曲线,描记时将潮气量表连接于流量传感器,记录呼气支呼气起始时的潮气量(VT1)和呼气结束时的潮气量(VT2),计算其差值(ΔVT=VT1-VT2)；同时记录呼气过程中流量传感器显示的潮气量(VT3)和预设潮气量(VT4)；并对ΔVT与VT3以及VT4与VT1进行相关性分析.结果 ΔVT为(417.40±119.68) ml,VT3为(399.29±121.36) ml；ΔVT与VT3具有很好的相关性(r=0.99,P=0.000),说明呼气支ΔVT与肺内陷闭气体量相关.VT4为(908.21±106.52) ml,VT1为(892.26±106.32) ml；VT4与VT1具有很好的相关性(r=0.99,P=0.000).结论 ARDS患者可能因呼气末部分气体陷闭,导致死腔增加,显示P-V曲线呼气支无法回到基点,且呼气支ΔVT与陷闭气体量成反比.
목적 이용준정태법묘기급성호흡군박종합정(ARDS)환자압력-용적곡선(P-V곡선),분석기호기지적회귀점여호기말사강변화적관계.방법 채용전첨성연구방법,선취본원14례접수궤계통기적ARDS환자,용준정태법묘기P-V곡선,묘기시장조기량표련접우류량전감기,기록호기지호기기시시적조기량(VT1)화호기결속시적조기량(VT2),계산기차치(ΔVT=VT1-VT2)；동시기록호기과정중류량전감기현시적조기량(VT3)화예설조기량(VT4)；병대ΔVT여VT3이급VT4여VT1진행상관성분석.결과 ΔVT위(417.40±119.68) ml,VT3위(399.29±121.36) ml；ΔVT여VT3구유흔호적상관성(r=0.99,P=0.000),설명호기지ΔVT여폐내함폐기체량상관.VT4위(908.21±106.52) ml,VT1위(892.26±106.32) ml；VT4여VT1구유흔호적상관성(r=0.99,P=0.000).결론 ARDS환자가능인호기말부분기체함폐,도치사강증가,현시P-V곡선호기지무법회도기점,차호기지ΔVT여함폐기체량성반비.
Objective To trace pressure-volume curves (P-V curves) with quasi-static technique in acute respiratory distress syndrome (ARDS) patients,and using it to explain the relationship between the end point of the expiratory limb and the change in the dead space of expiration.Methods A prospective study was conducted.Fourteen ARDS patients receiving mechanical ventilation were included in the study.When P-V curves was traced with quasi-static technique,the spirometer was connected to the flow sensor.The start point of the expiratory limb was defined as tidal volume 1 (Vr1) and the end point as VT2,and the difference between them (ΔVT=VT1-VT2) was calculated.The VT of spirometer (named VT3) and the predetermined VT (VT4) were recorded.Correlations of Δ VT and VT3,as well as VT4 and VT1,were analyzed with correlation analysis.Results Δ VT was (417.40 ± 119.68) ml,and VT3 was (399.29 ± 121.36) ml,Δ VT and VT3 showed a good correlation (r=0.99,P=0.000),demonstrating that the Δ VT of the expiratory limb was correlated with the volume trapped in lung.VT4 was (908.21 ± 106.52) ml,and VT1 was (892.26 ± 106.32) ml,and they showed a good correlation (r=0.99,P=0.000).Conclusion Because of part of the gas trapped at the end of expiration in ARDS patients,the dead space is increased,showing that the expiratory limb of the P-V curve cannot return to the base points,and the Δ VT of the expiratory limb is inversely proportional to the gas volume trapped in lung.