压力释放通气模式对重型颅脑创伤患者颅内压和低氧血症影响的临床观察  

Clinical observations on the effect of airway pressure release ventilation on intracranial pressure and hypoxemia of patients with severe traumatic brain injury

作　　者：翟国岩 张彬[1] 

机构地区：[1]天津市第四医院脑系科,300222

出　　处：《中国现代神经疾病杂志》2013年第4期338-341,共4页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：观察并比较压力释放通气(APRV)和压力控制通气(PCV)模式对重型颅脑创伤并发低氧血症患者脑血氧代谢的改善效果。经颅内压、脑血流、氧分压等指标监测显示,11例患者经APRV模式辅助呼吸30min后低氧血症即得到明显改善,而颅内压平均值与PCV模式十分相近(P>0.05);在APRV模式下颈内动脉血流量和动脉血氧分压提高,分别为(528.82±65.27)ml/min和(132.49±20.30)mmHg,PCV模式为(430.27±33.44)ml/min和(79.38±10.22) mm Hg,两种通气模式对脑氧代谢改善效果差异有统计学意义(均P<0.05)。提示APRV模式可在不增加颅内压的情况下,更好地改善氧供和低氧血症。The article aims to observe and compare the efficiency of airway pressure release ventilation （APRV） and pressure controlled ventilation （PCV） on patients with severe traumatic brain injury （sTBI） complicated with hypoxemia. The monitoring of intracranial pressure （ICP）, cerebral blood flow （CBF） and arterial partial pressure of oxygen （PaO2） showed 11 patients with hypoxemia had been significantly improved by 30 minutes of APRV. The ICP in APRV was similar with that in PCV （P 〉 0.05）. CBF and PaO2 under APRV mode were （528.82± 65.27） ml/min and （132.49± 20.30） mm Hg respectively, and （430.27 ± 33.44） ml/min and （79.38± 10.22） mm Hg respectively under PCV mode. The differences were statistically significant （P 〈 0.05, for all）. Therefore, APRV could be effective in improving oxygen supply and hypoxemia without increasing ICP.

关 键 词：连续气道正压通气 颅脑损伤 缺氧 颅内压 

分 类 号：R651.1[医药卫生—外科学]