CAJ | 학술논문

目的：探讨无创正压机械通气不同的通气模式治疗慢性阻塞性肺疾病(简称慢阻肺)急性加重期呼吸衰竭的疗效。方法采用前瞻性随机对照研究，入选120例患者按随机数字表分别进入不同通气组，观察血气指标变化、通气效果和呼吸机相关并发症发生率。结果呼吸机治疗6~8h、24h、3d和7d时，观察组患者PH值上升和PaCO2降低较对照组有所改变，但组间无统计学差异。 PRVC观察组通气参数VT、TA和TB显著升高， VE、RR、Lleak 显著降低。机械通气所致胃肠胀气 PRVC 组患者例数明显减少(8．33%、16．67%)，其余各种并发症两组间无统计学差异。结论压力调节容积控制通气模式减少呼吸肌做功，人机协调性好，较双水平正压通气( BiPAP)显示出一定的优越性。
목적：탐토무창정압궤계통기불동적통기모식치료만성조새성폐질병(간칭만조폐)급성가중기호흡쇠갈적료효。방법채용전첨성수궤대조연구，입선120례환자안수궤수자표분별진입불동통기조，관찰혈기지표변화、통기효과화호흡궤상관병발증발생솔。결과호흡궤치료6~8h、24h、3d화7d시，관찰조환자PH치상승화PaCO2강저교대조조유소개변，단조간무통계학차이。 PRVC관찰조통기삼수VT、TA화TB현저승고， VE、RR、Lleak 현저강저。궤계통기소치위장창기 PRVC 조환자례수명현감소(8．33%、16．67%)，기여각충병발증량조간무통계학차이。결론압력조절용적공제통기모식감소호흡기주공，인궤협조성호，교쌍수평정압통기( BiPAP)현시출일정적우월성。
Objective To explore the curative effect of different ventilating modes by noninvasive positive pressure ventilation ( NPPV) in the treatment of AECOPD patients complicated with respiratory failure. Methods 120 AECOPD patients were randomly divided into two groups. Their arterial blood gas, ventilation parameters and in-cidence of ventilator-associated complications were observed. Results The value of PH increased and the level of PaCO2 decreased in the observation group at the time points of 6-8h, 24h, 3d and 7d after ventilation, but there was no significant difference between the two groups. In the observation group, the mean value of VT, TA and TB in-creased significantly, and the mean value of VE, RR and Lleak decreased while compared with the control group. The number of flatulence patients in the observation group were significantly less than that of the control group (8. 33%, 16. 67%). There was no significant difference in other complications between the two groups. Conclusion Compared with BiPAP mode, the pressure regulating volume control ( PRVC) mode by NPPV can reduce breathing work and patient-ventilator asynchrony.