压力控制机械通气模式在ARDS患者中的应用  

Application of Pressure-Controlled Mechanical Ventilation Mode in Patients with ARDS

作　　者：徐萌[1] 郭伟峰[1] 王宝玉 林天来[1] XU Meng;GUO Wei-feng;WANG Bao-yu;LIN Tian-lai(The Quanzhou First Hospital Affiliated to Fujian Medical University,Fujian Quanzhou 362000)

机构地区：[1]福建医科大学附属泉州第一医院,福建泉州362000

出　　处：《深圳中西医结合杂志》2021年第20期125-127,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探讨压力控制模式(PCV)治疗对急性呼吸窘迫综合征(ARDS)患者血流动力学影响。方法:选择2019年10月至2020年9月福建医科大学附属泉州第一医院收治的87例ARDS患者,按随机数字表法分为对照组(43例)和观察组44例。两组均接受常规治疗和生命体征监测,对照组43例采用容量控制通气模式(VCV),观察组44例采用PCV。比较两组患者血气、血流动力学情况。结果:治疗前,两组患者的血气指标比较,差异无统计学意义(P>0.05);治疗后,两组患者的动脉血氧分压(PaO_(2))、动脉血氧合指数(OI)水平均升高,动脉血二氧化碳分压(PaCO_(2))水平均降低,且观察组的PaO_(2)、OI水平高于对照组,PaCO_(2)水平低于对照组,差异均具有统计学意义(P<0.05)。治疗前,两组患者的平均动脉压(MAP)、心率(HR)水平比较,差异均无统计学意义(P>0.05);治疗后,两组患者的MAP比较,差异无统计学意义(P>0.05);观察组的HR水平低于对照组,差异具有统计学意义(P<0.05)。结论:PCV与VCV两种模式均能有效改善ARDS患者的氧合与HR,减小血流动力学的波动,但PCV改善氧合、恢复心率的效果更佳。Objective To explore the effect of pressure control mode (PCV) therapy on hemodynamics in patients with acute respiratory distress syndrome (ARDS).Methods 87 patients with ARDS admitted to Quanzhou First Hospital Affiliated to Fujian Medical University From October 2019 to September 2020,were divided into control group (43 cases) and observation group(44 cases) according to the random number table method.Both groups received conventional treatment and vital signs monitoring,43 cases in the control group used volume controlled ventilation (VCV),and 44 cases in the observation group used PCV.Compare the blood gas and hemodynamics between the two groups.Results Before treatment,there was no significant difference in blood gas conditions between the two groups of patients (P > 0.05);after treatment,the arterial partial pressure of oxygen (PaO_(2)),oxygenation index (OI) levels increased,and the partial pressure of carbon dioxide (PaCO2) decreased,and the PaO_(2)and OI levels of the observation group were higher than those of the control group,and the PaCO_(2)level was lower than that of the control group.The differences were statistically significant (P < 0.05).Before treatment,there was no significant difference in mean arterial pressure (MAP) and heart rate (HR) levels between the two groups of patients (P > 0.05);after treatment,there was no significant difference in MAP between the two groups of patients (P > 0.05);The HR level of the observation group after treatment was lower than that of the control group,and the difference was statistically significant (P < 0.05).Conclusion Both PCV and VCV can effectively improve the oxygenation and HR of ARDS patients,and reduce the fluctuation of hemodynamics,but PCV is more effective in improving oxygenation and restoring heart rate.

关 键 词：急性呼吸窘迫综合征 压力控制模式 容量控制通气模式 

分 类 号：R563.8[医药卫生—呼吸系统]