适应性支持通气对危重支气管哮喘患者呼吸力学的影响  

Efficacy of Adaptive Support Ventilation on the Respiratory Mechanics of Patients With Critical Bronchial Asthma

作　　者：谭辉[1] 

机构地区：[1]郴州市第一人民医院呼吸内科,湖南郴州423000

出　　处：《南华大学学报（医学版）》2010年第4期524-526,共3页Journal of Nanhua University(Medical Edition)

摘　　要：目的探讨适应性支持通气(ASV)对危重支气管哮喘病人呼吸力学的影响。方法采用自身对照,对23例危重支气管哮喘病人,序贯应用压力控制同步间歇指令-压力支持通气模式(P-SIMV-PSV)和ASV模式进行机械通气(MV),记录两种模式下各项呼吸力学参数。结果患者总呼吸频率明显降低(P<0.05),自主呼吸频率增加(P>0.05),潮气量(Vt)明显升高(P<0.05),气道峰压、平台压(Pp lat)和平均气道压(Pawm)明显下降(P<0.05),顺应性(Cst)无明显变化,P0.1(0.1秒的口腔闭合压)稍有下降(P>0.05),生命体征、血气分析和血流动力学指标无明显变化。结论 ASV可根据危重支气管哮喘病人的呼吸力学状况自动调整吸气压力支持水平,提高潮气量、降低呼吸频率,而对血流动力学和生命体征无影响。Objective To explore the efficacy of adaptive support ventilation on the respiratory mechanics of patients with critical bronchial asthma. Methods From November 2006 to August 2009,23 patients with critical bronchial asthma had ventilation by the same ventilator in the First People＇ s Public Hospital of Chenzhou. They were all applied with pressure control synchronized intermittent mandatory ventilation plus inspiration pressure support （ P - SIMV - PSV ） and adaptive support ventilation （ ASV ） respectively during the stage. The parameters of respiratory mechanics, hemodynamies and blood analysis were compared before and after ASV. Results Total respiratory rates decreased significantly （ P 〈 0.05 ） and spontaneous respiratory rates improved （ P 〉 0.05 ）. The tidal volume （ VT ） increased significantly （ P 〈 0.05 ）. The peak pressure （ Ppeak ） plateau pressure （ Pplat ） and mean airway pressure （ Pawm ） decreased significantly （ P 〈 0.05 ）. The compliance （ Cst） has no changes. P0.1 decreased （ P 〉 0.05 ）. No changes were noted in the parameters of vital signs, blood analysis and hemodynamics. Conclusion ASV may automatically adjust inspiratory pressure,the tidal volume and respiratory rate with the respiratory mechanics of each patient breath,which may not affect hemodynamics and vital signs.

关 键 词：适应性支持通气 危重支气管哮喘 机械通气 

分 类 号：R562.25[医药卫生—呼吸系统]