慢性阻塞性肺疾病呼吸衰竭撤机中比例压力支持通气的调节方法  

Adjustment methods of proportional pressure support on weaning during acute aggravation in chronic respiratory failure patients with chronic obstructive pulmonary disease

作　　者：王士泳[1] 展春[1] 张纳新[1] 秦英智[1] 徐磊[1] 

机构地区：[1]天津市第三中心医院ICU,300170

出　　处：《中国危重病急救医学》2004年第7期421-423,共3页Chinese Critical Care Medicine

基　　金：天津市卫生局科研基金资助项目 ( 2 0 0 10 171)

摘　　要：目的　探讨比例压力支持模式时比例调节法与目标调节法对慢性阻塞性肺疾病慢性呼吸衰竭急性加重患者机械通气参数调节的意义。方法　选择慢性阻塞性肺疾病慢性呼吸衰竭急性加重患者 75例 ,随机分为两组。采用脱逸法测定阻力和弹性回缩力 ,采用比例调节法和目标调节法分别调节呼吸机设定的流速辅助和容量辅助参数 ,以达到撤机目的。结果　两组患者测定的阻力、弹性回缩力 ,撤机时的流速辅助和容量辅助参数 ,通气时间和撤机成功率均无显著性差异。结论　脱逸法测定阻力和弹性回缩力操作简单。目标调节法能达到与比例调节法相同的调节目的和撤机成功率 。Objective To study the effects of two adjustment methods of proportional pressure support(PPS) on patients with acute aggravation in chronic respiratory failure of chronic obstructive pulmonary disease. Methods Seventyfive patients were randomized to two groups, 30 in proportional adjustment group and 45 in target adjustment group, respectively. Suitable flow assist(FA) and volume assist(VA) were adjusted with proportional adjustment and target adjustment methods respectively according to the ventilation parameters until the weaning of ventilation. Results There were no significant differences in resistance, elastic, FA as well as VA on weaning point, duration of mechanical ventilation, and successful weaning rate between the two groups(all P >0 05). Conclusion The same aim and successful weaning rate could be gained in the target adjustment group compared with the proportional adjustment group. More clinical experience and more intensive care would be needed in the target adjustment group.

关 键 词：肺疾病 阻塞性 慢性 呼吸衰竭 比例压力支持 撤机 

分 类 号：R563.8[医药卫生—呼吸系统]