CAJ | 학술논문

目的：探讨适应性支持通气在慢性阻塞性肺疾病（COPD）合并肺栓塞老年患者中应用效果观察及护理体会。方法选择 COPD 合并肺栓塞老年患者56例，将其随机分为两组，每组28例，在综合治疗的基础上，治疗组患者接受适应性支持通气，对照组压力支持同步间歇指令通气＋呼气末正压，比较两组患者机械通气治疗过程中，呼吸力学和临床护理监测指标变化。护理特点：应用呼吸机辅助通气前对患者做好心理护理，同期过程中注意患者的一般情况及呼吸机监控数据变化，注意人工气道护理。对于抗凝或溶栓患者，注意此类药物的监测疗效及不良反应。协助完成各项出凝血指标的测定。结果与对照组比较，治疗组患者呼吸力学参数明显改善。结论适应性支持通气，结合综合护理措施可提高患者潮气量，降低呼吸频率，呼吸肌做功减少，改善人机协调性。
목적：탐토괄응성지지통기재만성조새성폐질병（COPD）합병폐전새노년환자중응용효과관찰급호리체회。방법선택 COPD 합병폐전새노년환자56례，장기수궤분위량조，매조28례，재종합치료적기출상，치료조환자접수괄응성지지통기，대조조압력지지동보간헐지령통기＋호기말정압，비교량조환자궤계통기치료과정중，호흡역학화림상호리감측지표변화。호리특점：응용호흡궤보조통기전대환자주호심리호리，동기과정중주의환자적일반정황급호흡궤감공수거변화，주의인공기도호리。대우항응혹용전환자，주의차류약물적감측료효급불량반응。협조완성각항출응혈지표적측정。결과여대조조비교，치료조환자호흡역학삼수명현개선。결론괄응성지지통기，결합종합호리조시가제고환자조기량，강저호흡빈솔，호흡기주공감소，개선인궤협조성。
Objective To investigate the clinical value of the adaptive support ventilation(ASV)in elderly pa-tients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary thromboembolism. Methods Fifty-six cases of COPD complicated with pulmonary thromboembolism and respiratory failure needed mechanical ventilation were randomly divided into two groups with 28 cases in each group. The treated group was assigned to adaptive support ventila-tion,while the other 28 cases of the control group were assigned to pressure support synchronized mandatory ventilalion ex-haust ventilation plus positive end-expiratory pressure(P-SIMV + PEEP)support. Both groups were all ventilated until wea-ning,respiratory mechanics indicators were compared between the two groups. Results Compared with the control group, there was significantly reduced respiratory frequency,increased tidal volume(VT),declined plateau pressure(Pplat), peak airway pressure(Ppeak)and inspiratory resistance(R),increased static compliance(Cstat). Reduced WOBimp and PTP,and shorter duration of mechanical ventilation(all P ﹤ 0. 05). Conclusions Compared with P-SIMV mode,ASV support can enhance spontaneous tidal volume,reduce respiratory rate and respiratory muscle work,increase man-machine harmonization,and shorten the duration of mechanical ventilation.