适应性支持通气(ASV)在重症肺炎机械通气患者中的应用  

Application of adaptive support ventilation in mechanically ventilated patients with severe pneumonia

作　　者：刘真君[1] 李懿[1] 熊中华[1] 

机构地区：[1]四川省肿瘤医院ICU,四川成都610041

出　　处：《吉林医学》2011年第8期1464-1465,共2页Jilin Medical Journal

摘　　要：目的:探讨适应性支持通气(ASV)在重症肺炎机械通气患者中的应用,并与间断正压通气(IPPV)比较。方法纳入重症肺炎机械通气患者22例,通过自身前后对照比较ASV和IPPV在呼吸力学、血气分析、血流动力学的差异性。结果:本研究显示ASV通气模式较IPPV模式气道峰压(Ppeak)、呼吸频率(RR)、呼吸机作功(WOBV)、吸气阻力(Rins)和PaCO2显著降低(P<0.05),而潮气量/理想体重(VT/PBW)和pH值显著升高(P<0.05)。ASV通气模式下血流动力学指标每搏排出量(SV)和心排出量(CO)显著升高(P<0.05),心率(HR)、平均动脉压(MAP)、左心室射血前期(PEP)、外周血管阻力指数(SVRI)、加速指数(ACI)等指标没有差异性。结论ASV模式在呼吸力学、血气分析结果方面较IPPV模式更能满足患者机械通气的需求,并且在对血流动力学方面影响较少。Objective To investigate the application of adaptive support ventilation in mechanically ventilated patients with severe pneumonia and compared with intermittent positive pressure ventilation （IPPV）. Method Severe pneumonia in 22 mechanically ventilated patients were included. Compared differences of ASV and IPPV in respiratory mechanics, blood gas analysis, hemodynamic parameters. Results Compared with IPPV, Ppeak, RR, WOBV, Rins and PaCO2 in ASV decreased significantly （P 〈 0. 05 ） , while VT/PBW and PH were significantly higher（ P 〈 0. 05 ）. In ASV, SV and CO were significantly higher （ P 〈 0. 05 ）, but HR, MAP, PEP, SVRI and ACI did not differ. Conclusion ASV better meets the needs of patients than IPPV in respiratory mechanics and blood gas analysis, and less im- pact on hemodynamics.

关 键 词：适应性支持通气 间断正压通气 血流动力学 

分 类 号：R563.1[医药卫生—呼吸系统]