适应性支持通气（ASV）在COPD和ARDS／ALI患者中通气方式的差异性研究  

Study the Differences of ASV in COPD and ARDS/ali Patients

作　　者：刘真君[1] 李懿[1] 熊中华[1] LIU Zhen-jun, LI Yi, XIONG Zhong-hua （ICU Department,Sichuan Turnout Hospital,Chengdu 610041,China）

机构地区：[1]四川省肿瘤医院ICU,四川成都610041

出　　处：《医学信息》2011年第5期1277-1279,共3页Journal of Medical Information

摘　　要：目的探讨适应性支持通气（ASV）在COPD和ARDS／ALI患者中通气方式的差异。方法纳入COPD患者24例，ARDS／ALI患者21例．无肺部疾病组24例．观察在ASV模式下呼吸力学指标的不同。结果COPD和ARDS／ALI患者平均气道压（Pmean）显著高于元肺部疫病组（P〈0．05）；COPD患者的静态顺应性（Cstat）较无肺部疾病组显著升高（P〈0．05）；ARDS／ALI患者的Cstat显著下降（P〈0．05），而吸气阻力（Rins）显著升高（P〈0．05）。在ASV模式下COPD患者的通气方式表现升高的潮气量／理想体重（VT／PBW）值（P〈O．05），呼吸频率（RR）有下降的趋势。ARDS／ALI患者表现为升高的RR值。而VT／PBW值下降（P〈0．05），与COPD患者比较VT／PBW的下降更显著（P〈0．01）。结论ASV在不同的Cstat和Rins等因素下表现为不同的通气方式，主要为VT／PBW和RR的不同，符合COPD和ARDS／ALI患者的通气需求。Objective To investigate breathing pattern differences of adaptive support ventilation in COPD and ARDS/ALI patients. Methods 24 patients with COPD, 21 patients with ARDS/ALI, 24 cases without lung disease were included. Differences of respiratory mechanics in the ASV mode were observed. Results Pmean in COPD and ARDS/ALI patients was significantly higher than those without lung disease group （P〈0.05）; Cstat in COPD patients were significantly higher than those without lung disease （P〈0.05）; Cstat in ARDS/ALI patients decreased significantly （P〈0.05）, and Rins increased significantly（P〈0.05）. In the ASV mode, VT/PBW elevated（P〈0.05） and RR declined in COPD patients. But in ARDS/ALI patients, VT/PBW and RR acted reversely （P〈0.05）, compared with COPD patients, VT/PBW declined more significantly （P〈0.01）. Conclusions Based on different Cstat and Rins factors, ASV ventilated differently, mainly for VT/PBW and RR. ASV fullfilled COPD and ARDS/ALI patients＇ventilation requirements.

关 键 词：适应性支持通气 慢性阻塞性肺疾病 急性呼吸窘迫综合征/急性肺损伤 

分 类 号：R511.6[医药卫生—临床医学;医药卫生—内科学]