MRV、PSV呼吸衰竭患者呼吸力学影响的随机对照研究  

Effects of MRV and PSV on respiratory mechanics in patients with type Ⅱ respiratory failure

作　　者：张婷[1] 王导新[1] 李生锦[1] 凌平[2] 

机构地区：[1]重庆医科大学附属第二医院呼吸科,400010 [2]重庆医科大学附属第二医院外科ICU,400010

出　　处：《重庆医学》2006年第16期1473-1474,共2页Chongqing medicine

摘　　要：目的比较MRV、PSV、CMV对2型呼吸衰竭患者呼吸功能的影响。方法42例2型呼吸衰竭患者首先行CMV模式,然后随机分别行PSV模式及MRV模式,每种模式持续运行60min,潮气量每分钟通气量都相似,分别观察气道吸气峰压(PIP),气道平均压(Pm)、平台压(Pp)、内源性呼气末正压(PEEPi)、气道阻力(R)、胸肺顺应性(Cstat)及血气变化、循环情况。结果MRV及PSV模式的PIP、Pp、Pm、R明显低于CMV,差异有统计学意义(P<0.05),Cstat有增加的趋势,MRV模式的PEE-Pi水平低于PSV及CMV,差异有统计学意义(P<0.05),患者的同步性好。血气的变化、循环差异无统计学意义(P>0.05)。结论MRV、PSV可降低2型呼吸衰竭患者PIP、Pp、Pm水平,MRV可降低PEEPi,因而是一种肺保护性通气策略,可能在防止肺气压伤的发生中发挥有利的作用。Objective To investigate the effects of MRV,PSV and CMV on respiratory mechanics in patients with type Ⅱ respiratory failure.Methods Fourty-two patients with type Ⅱ respiratory failure received ventilation in CMV mode and then in MRV or PSV.After continuous operation in each mode for 60min and the tidal volume(VT) and minute ventilation(MV) in MRV mode were the same as those in PSV mode.PIP,Pp,Pm,PEEPi,R,C,blood gas changes and circulatory index were observed during ventilation.Results PIP,Pp,Pm,R in patients in MRV mode and PSV mode were significantly lower than those in CMV mode(P<0.05).PEEPi in patients in MRV were lower than those in PSV and CMV(P<0.05).The compliance had the tendency to increase.No other significant differences were found.Conclusion MRV,PSV can low PIP,Pp,Pm in patients with type Ⅱ respiratory failure.MRV can low PEEPi,thus it is one of lung protective ventilation strategies and play a beneficial role in preventing lung barotraumas.

关 键 词：呼吸功能 2型呼吸裹竭 

分 类 号：R563.8[医药卫生—呼吸系统]