肺泡动脉氧分压差对机械通气时间的应用价值  

Application value of the difference of alveoli-arterial oxygen partial pressure on the duration of mechanical ventilation

作　　者：沈亚伟[1] 唐宝龙[1] 常静静 SHEN Ya-wei;TANG Bao-long;CHANG Jing-jing(Department of CCM,the Fourth Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230000,China)

机构地区：[1]安徽医科大学第四附属医院重症医学科

出　　处：《临床肺科杂志》2019年第9期1629-1632,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨肺泡动脉氧分压差及其变化值,应用于早期评估机械通气时间的临床价值。方法回顾性分析38例急性I型呼吸衰竭行有创机械通气并成功脱机的患者,记录机械通气前、机械通气后6小时肺泡动脉氧分压差、动脉血氧分压、氧合指数、心率、机械通气时间。计算机械通气前后肺泡动脉氧分压差变化值,比较机械通气前后肺泡动脉氧分压差的变化。并按机械通气平均时间划分为小于平均时间组A组和大于平均时间组B组,进一步比较组间肺泡动脉氧分压差的差异。结果38例患者机械通气6小时前后肺泡动脉氧分压差、动脉血氧分压、氧合指数、心率等各项指标明显改善,且差异有统计学意义(P﹤0.05)。A、B两组间比较,机械通气前肺泡动脉氧分压差,差异无统计学意义(P>0.05),机械通气6小时后肺泡动脉氧分压差差异有统计学意义(P<0.05),且机械通气前后肺泡动脉氧分压差的变化值同样存在统计学差异(P<0.05)。结论动态监测肺泡动脉氧分压差有助于指导临床评估机械通气时间。Objective To investigate the clinical value of alveolar-arterial oxygen partial pressure difference on the duration of mechanical ventilation in the early time. Methods The clinical data of 38 patients with acute type I respiratory failure with invasive mechanical ventilation and finally weaning successfully were retrospectively analyzed. The difference of alveoli-arterial oxygen pressure, arterial oxygen pressure, oxygenation index, heart rate before and 6 hours after mechanical ventilation and the duration of mechanical ventilation were collected. The variation of the difference of alveoli-arterial oxygen pressure was calculated. The difference of alveoli-arterial oxygen partial pressure before and 6 hours after mechanical ventilation was compared. According to the mean time of mechanical ventilation, they were divided into the group A (less than the mean time) and the group B (more than the mean time). The difference of alveolar-artery oxygen partial pressure was further compared between the two groups. Results 6 hours after mechanical ventilation, 38 cases had the significant differences in the difference of alveoli-arterial oxygen partial pressure, arterial oxygen pressure, oxygenation index and heart rate ( P< 0.05). There was no significant difference in the difference of alveoli-arterial oxygen partial pressure before mechanical ventilation between the group A and B ( P> 0.05). But there was significant difference in the difference of alveolar-arterial oxygen partial pressure 6-hour after mechanical ventilation, so was the variation ( P< 0.05). Conclusion Dynamic monitoring on the difference of alveolar-arterial oxygen partial pressure can guide clinical evaluation of the duration of mechanical ventilation.

关 键 词：肺泡动脉氧分压差 机械通气 呼吸衰竭 

分 类 号：R56[医药卫生—呼吸系统]