双相正压通气在体外循环心脏手术后的应用  

Beneficial effects of bidirectional positive airway pressure after extracorporal cardiac surgery

作　　者：赵枫[1] 徐志云[1] 邹良建[1] 梅举[1] 

机构地区：[1]第二军医大学附属长海医院胸心外科,上海200433

出　　处：《上海医学》2005年第8期664-666,共3页Shanghai Medical Journal

摘　　要：目的评价双相正压通气(BIPAP)在体外循环心脏手术后的应用价值.方法120例体外循环心脏手术后拔除气管插管的患者,其中对氧合指数(PaO2/FiO2)＜180的31例患者予以面罩式BIPAP支持通气,BIPAP次数平均为(7.3±3.6)次,通气时间为25～180 min/次.结果BIPAP治疗后患者的PaO2/FiO2显著提高(128±43比298±62,P＜0.01),治疗后PaO2/FiO2与未行BIPAP治疗者的差异无显著性.结论BIPAP可有效改善体外循环心脏手术后肺的氧合功能.Objective To evaluate the beneficial effects of bidirectional positive airway pressure after extracorporal cardiac surgery. Methods Bidirectional positive airway pressure for adult patients undergoing surgery with cardiopulmonary bypass was performed for supportory the oxygenation. Among 120 consecutive patients, 31 patients whose PaO2/FiO2 decreased to less than 180 after extubation were assigned to the intermittent 25～180 min bidirectional positive airway pressure （7.3±3.6 times per patient）. Results Bidirectional positive airway pressure improved oxygenation（PaO2/FiO2： 128±43 vs 298±62, P=0.004） and allowed the poor oxygenation patients to maintain PaO2/FiO2 levels after extubation showing no significance to those of the patients without such procedure. Conclusions The bidirectional positive airway pressure therapy after extubation was effective to improve the oxygenation in adult patients undergoing cardiac surgery with prolonged cardiopulmonary bypass. （Shanghai Med J, 2005,28：664-666）

关 键 词：体外循环 双相正压通气 氧合 术后处理 机械通气 心脏手术后 BIPAP FIO2 PAO2 气管插管 

分 类 号：R654.2[医药卫生—外科学]