无创气道正压通气下呼气末测算气道阻力和肺顺应性实验研究  

Calculating Airway Resistance and Lung Compliance at Expiration End under Non-invasive Positive Pressure Ventilation:An Experimental Study

作　　者：袁越阳 解立新[2] 陈宇清 胡兴硕 黄皓轩 李立雄 徐强 YUAN Yueyang;XIE Lixin;CHEN Yuqing;HU Xingshuo;HUANG Haoxuan;LI Lixiong;XU Qiang(Innovation Base of Diagnostic and Therapeutic Respiratory Equipment,Hunan City University,Yiyang 413099,Hunan,China;Department of Respiratory and Critical Care Medicine,Chinese PLA General Hospital,Beijing 100853,China;Department of Respiratory Medicine,Shanghai Chest Hospital,Shanghai 200030,China;Hunan Micomme Medical Technology Co.,Ltd.,Changsha 410000,China)

机构地区：[1]湖南城市学院呼吸诊疗装备创新基地,湖南益阳413099 [2]中国人民解放军总医院呼吸与危重症医学部,北京100853 [3]上海市胸科医院呼吸内科,上海200030 [4]湖南明康中锦医疗科技股份有限公司,长沙410000

出　　处：《医用生物力学》2024年第4期750-755,共6页Journal of Medical Biomechanics

基　　金：国家重点研发计划项目(2021YFC0122500);国家级大学生创新训练项目(S202311527084)。

摘　　要：目的采用呼气末压力短暂释放的方式,测算无创正压通气(non-invasive positive pressure ventilation,NPPV)条件下的气道阻力(R)和肺顺应性(C),并评估其测算精度。方法首先,将测算方法程序移植到NPPV呼吸机的控制器,设计基于主动模拟肺ASL5000的通气实验平台。然后,模拟正常成人(R=5 cmH_(2)O,C=50 mL/cmH_(2)O。1 cmH_(2)O=0.098 kPa)、急性呼吸窘迫综合征成人患者(R=10 cmH_(2)O,C=30 mL/cmH_(2)O)和慢性阻塞性肺疾病成人患者(R=20 cmH_(2)O,C=50 mL/cmH_(2)O)的R和C进行实验。结果测算所得R最大相对误差达到-12.67%,出现在对正常成人的测定;C最大相对误差达到17.37%,出现在对急性呼吸窘迫综合征成人患者的测定。采用均值配对双样本t检验法对每组测试数据进行分析,差异没有统计学意义(P>0.05)。结论实验所得R、C与在ASL5000上的设置值相一致。NPPV下呼气末R、C的测算方法具有良好的可行性,其实现与应用有助于呼吸机通气治疗的精准化和个体化。Objective Airway resistance(R)and lung compliance(C)under non-invasive positive pressure ventilation(NPPV)conditions were measured using a brief pressure release at the end of expiration,and the measurement accuracy was also evaluated.Methods An NPPV respirator was developed by programming a method for calculating R and C.An experimental platform based on the active servo lung ASL5000 was designed.By simulating a healthy adult(R=5 cmH_(2)O and C=50 mL/cmH_(2)O,1 cmH_(2)O=0.098 kPa),an adult patient with acute respiratory distress syndrome(R=10 cmH_(2)O and C=30 mL/cmH_(2)O),and an adult patient with chronic obstructive pulmonary disease(R=20 cmH_(2)O and C=50 mL/cmH_(2)O),a series of experiments for calculating the R and C were conducted.Results The maximum relative error of R was-12.67%,which occurred in calculating the R of an average adult.The maximum relative error of C was 17.37%,which occurred when calculating the C values of patients with acute respiratory distress syndrome.Each group of data was analyzed using a paired t-test,which showed statistically significant differences(P>0.05).Conclusions The calculation method for R and C at the end of expiration during NPPV is feasible,and its realization and application will be beneficial for achieving precise and personalized respiratory ventilation.

关 键 词：无创通气 气道阻力 顺应性 

分 类 号：R318.01[医药卫生—生物医学工程]