压力控制通气对重症哮喘患者中心静脉压的影响  

Effect of pressure controlled ventilation on central venous pressure in patients with severe asthma

作　　者：王德锋[1] 谢关平 聂晓东[2] WANG Defeng;XIE Guanping;NIE Xiaodong(Department of Emergency Medicine,the Fourth Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang330003,China;Department of Respiratory,the Fourth Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang330003,China)

机构地区：[1]南昌大学第四附属医院急诊科,江西南昌330003 [2]南昌大学第四附属医院呼吸科,江西南昌330003

出　　处：《中国当代医药》2023年第7期77-79,83,共4页China Modern Medicine

基　　金：江西省教育厅科学技术研究项目(GJJ160176)。

摘　　要：目的探讨压力控制通气对重症哮喘患者中心静脉压的影响。方法选取2018年10月至2021年10月南昌大学第四附属医院收治的需要实施有创机械通气的32例重症哮喘患者作为研究对象,分别测定内源性呼气末正压(PEEP)为0、6、12 cmH2O时的中心静脉压(CVP)值和0°、40°及80°体位时的CVP值。结果CVP测量值和PEEP呈正相关(r=0.429,P<0.01);PEEP在6、12 cmH2O时测得的CVP值高于0 cmH2O时,差异有统计学意义(P<0.05);CVP测量值与体位呈负相关(r=-0.482,P<0.01);40°及80°体位时测得的CVP值低于0°,差异有统计学意义(P<0.05)。结论PCV通气模式下,重症哮喘患者的CVP与PEEP呈正相关,体位与CVP测量值呈负相关,非平卧位测CVP时,不必改为平卧位,可经线性回归方程估算出0°体位时的CVP真实值。Objective To investigate the effect of pressure controlled ventilation on central venous pressure in patients with severe asthma.Methods Thirty-two patients with severe asthma requiring invasive mechanical ventilation admitted to the Fourth Affiliated Hospital of Nanchang University from October 2018 to October 2021 were selected as the research objects.The central venous pressure(CVP)values at endogenous positive end expiratory pressure(PEEP)of 0,6,12 cmH2O and the CVP values at 0°,40°,and 80°were measured,respectively.Results CVP was positively correlated with PEEP(r=0.429,P<0.01).PEEP measured CVP value at 6 and 12 cmH2O were higher than 0 cmH2O,the differences were statistically significant(P<0.05).CVP was negatively correlated with body position(r=-0.482,P<0.01).The CVP values measured at 40°and 80°were lower than those in 0°,and the differences were statistically significant(P<0.05).Conclusion Under PCV ventilation mode,the central venous pressure of patients with severe asthma was positively correlated with PEEP.There is a negative correlation between body position and CVP measurement value.When measuring CVP in non-supine position,it is not necessary to change to supine position,and the true CVP value in 0°position can be estimated by linear regression equation.

关 键 词：哮喘持续状态 间歇正压通气 中心静脉压 体位 

分 类 号：R562.25[医药卫生—呼吸系统]