Autoflow在AECOPD并发Ⅱ型呼吸衰竭54例中的应用  

Value of autoflow in therapy of patients with type Ⅱ respiratory failure caused by AECOPD

作　　者：杨渭临[1] 张晓艳 章琳[1] 孙师元[3] 

机构地区：[1]西安交通大学医学院第二附属医院老年呼吸科,西安710004 [2]西电集团医院呼吸内科 [3]西安交通大学医学院第二附属医院急诊科

出　　处：《陕西医学杂志》2014年第1期46-47,108,共3页Shaanxi Medical Journal

摘　　要：目的：探讨自动变流（Autoflow）在慢性阻塞性肺病急性发作（AECOPD）并发Ⅱ型呼吸衰竭患者机械通气中的临床应用价值。方法：54例AECOPD并发Ⅱ型呼吸衰竭患者，经气管插管行机械通气治疗，给予同步间歇指令通气（SIMV）＋压力支持通气（PSV），病情稳定后随机分为SIMV—PSV组（对照组）和SIMV—PSV＋AutoFlow组（治疗组）。继续治疗4～6h，对两组心率（HR）、平均动脉血压（MAP）、动脉血气（ABG）、浅快呼吸指数（f／VT）、撤机时间、气道吸气峰压（PIP）、气道平均压（Pmean）、气道阻力（R）、胸肺顺应性（C）和分钟通气量（VE）等数据进行统计学分析。结果：治疗组f／VT、撤机时间、Pmean、R低于对照组（P〈0．05）；PIP低于对照组（P〈0．01）；C高于对照组（P〈0．01）。结论：AECOPD并发Ⅱ型呼吸衰竭患者机械通气使用Autoflow既可以保证分钟通气量、降低气道压、减少人一机对抗，在一定程度上还可改善胸肺顺应性、减少患者在ICU住院时间。Objective：Investigating the clinical value of Autoflow in therapy of mechanically ventilated pa tients with RF Ⅱ （type Ⅱ respiratory failure） caused by AECOPD. Methods：When got stable, 54 patients with RF Ⅱ caused by AECOPD, who had received treatments of mechanically ventilation under SIMV＋ PSV mode though tracheal cannula, were divided into two groups as SIMV-PSV group and SIMV PSV＋Alow group. Then, after 4- 6 hours of continuous treatment, HR（heart rate）, MAP（mean arterial pressure）, ABG（arteriaI blood gases）, f/VT （frequency/tidal volume ratio）, weaning time, PIP（peak inflation pressure）, Pmean（mean airway pressure）, R（air- way resistance）, C（chest-lung compliance） and VE（minute ventilation） were recorded so that comparisons could be done. Results： Compared with SIMV-PSV group, f/VT, weaning time, Pmean and R in SIMV-PSV＋ Autoflow group were lower significantly （P〈0.05）, PIP was lower significantly （P〈0.01）, and C was higher significantly （P〈0.01）. Conclusions：Autoflow in mechanically ventilation treatments could ensure minute ventilation, decrease airway pressure and improve man machine counteraction, and in part, could also improve chest-lung compliance and decrease hospitalization time in ICU.

关 键 词：肺疾病 慢性阻塞性 并发症 呼吸功能不全 病因学 呼吸功能不全 治疗 通气 机 机械 

分 类 号：R563.8[医药卫生—呼吸系统]