无创正压通气压力支持水平对呼吸音的影响  

The infection of pressure support level of non-invasive positive pressure ventilation on the acoustic-based lung vibration

作　　者：赵生涛[1] 刘翱[1] 杨伟康[1] 樊满齐[1] 李妍[1] 李少莹[1] 周玉兰[1] 

机构地区：[1]成都军区昆明总医院呼吸内科,650032

出　　处：《实用医学杂志》2011年第23期4221-4223,共3页The Journal of Practical Medicine

摘　　要：目的:研究不同压力支持水平对正常健康人肺部呼吸音的影响。方法:选取20例健康成人,利用肺部振动反应成像系统(VRIxp)采集正常呼吸及配带口鼻面罩无创呼吸机辅助呼吸时的呼吸音图像变化。观察不同压力支持水平(0、2、4、8cmH2O)时最大能量桢图像、平均灰度值及吸气相曲线斜率变化。结果:健康人在正常呼吸时及压力支持水平分别为2、4、8cmH2O(PS-2,PS-4、PS-8)时最大呼吸音能量图面积分别为:(7.97±0.31)、(8.16±0.41)、(8.14±0.48)和(8.39±0.43)平方英寸,PS-8与其他压力支持水平间差异有统计学意义(P<0.05);吸气相曲线斜率分别为:1.26±0.41、1.13±0.27、1.17±0.24和1.42±0.31,PS-8与其他压力支持水平间差异有统计学意义(P<0.05)。平均灰度值分别为:96.96±8.47、96.48±13.02、94.46±10.34和96.92±13.65,不同压力支持水平间差异无统计学意义(P>0.05)。结论:无创呼吸机压力支持水平为8cmH2O时较2和4cmH2O改善通气作用明显。Objective To evaluate the influence of different pressure support level of non-invasive positive pressure ventilation on respiratory sound of healthy volunteers. Method Respiratory sounds of 20 adult healthy volunteers, during normal breath and non-invasive positive pressure ventilation on pressure support level of 2, 4, 8 cmH20 （PS12, PS-4,PS-8） were recorded and displayed by VRIXP, an acoustic-based imaging technique, which can turned vibration into a two-dimensional gray-scale image. Areas of the inspiratory maximal energy frame （MEF）, the mean gray-scale values and the slope rate of inspiratory curve were analyzed. Results The mean areas of MEF in normal breath, PS-2, PS-4, PS-8 were （7.97 ± 0.31）, （8.16 ± 0.4）, （8.14 ± 0.48） and （8.39 ± 0.43） square inches respectively. The mean gray scale values of MEF in normal breath, PS-2, PS-4, PS-8 were （96.96 ± 8.47）, （96.48 ±13.02）, （94.46 ± 10.34） and （96.92 ± 13.65） respectively （P 〉 0.05）. The mean slope rate of inspiratory curve in normal breath, PS-2, PS-4 and PS-8 were （ 1.26 ± 0.41 ）, （ 1.13 ± 0.27）, （ 1.17 ± 0.24） and （ 1.42 ± 0.31 ） respectively. There were significant differences between PS-8 and other pressure support levels in the mean areas of MEF and the mean slope rate of inspiratory curve （P 〈 0.05）. Conclusions Compared with 2 cmH20 and 4 cmH2O, non-invasive pressure support ventilation level of 8 cmH2O can improve ventilation obviously.

关 键 词：正压呼吸 压力支持 振动反应成像 图像面积 最大呼吸音能量图 呼吸曲线斜率 

分 类 号：R563.9[医药卫生—呼吸系统]