摘要
目的：探讨ＩＣＵ采用双相气道正压（ＢＩＰＡＰ）压力支持通气治疗多种心肺疾病的适应证范围、监测指标的选择和评价治疗作用。方法：对采用ＢＩＰＡＰ压力支持通气的３３例患者进行心率、血氧饱和度（ＳａＯ２）、平均血压（ＭＢＰ）、呼气末二氧化碳分压（ＰｅｔＣＯ２）、呼吸频率和节律及血气分析等指标的监测。结果：慢性阻塞性肺病（ＣＯＰＤ）并呼吸衰竭患者治疗２～４小时后ＰａＯ２和ＳａＯ２明显提高，通气前后比较Ｐ＜０．０５；ＰａＣＯ２和ＰｅｔＣＯ２亦有降低，但无显著性差异；能有效地改善支气管哮喘及阻塞性睡眠呼吸暂停综合征（ＯＳＡＳ）的通气状态；减慢急性肺水肿患者的心率，促进心功能的恢复；对于各种病因的低氧血症，治疗２～４小时后均得以纠正。结论：ＢＩＰＡＰ压力支持通气基本不影响血压，对心率和呼吸频率无负性影响，不增加循环系统负担，无明显并发症。
Objective:To investigate the indications,monitoring parameters,and therapeutic effects of bilevel positive airway pressure(BIPAP) ventilation treating heart and lung diseases and evaluate the therapeutic effect.Methods:Parameters including heart rate,arterial oxygen saturation (SaO 2),mean blood pressure,endtidal carbon dioxide pressure (PetCO 2),respiratory rate and rhythm,and blood gas analysis were monitored in 33 patients with BIPAP ventilation.Results:In patients with chronic obstructive pulmonary disease (COPD) complicated by respiratory failure,PaO 2 and SaO 2 were increased significantly after treatment for 2￣4 hours ( P <0 05),but the decreased PaCO 2 and PetCO 2 were found to be not significantly different statistically from pretreatment values.Using BIPAP ventilation,the ventilation status of patients with bronchial asthma and obstructive sleep apnea syndrome (OSAS) could be effectively improved,and the heart rates of patients with acute pneumochysis were slowed down,which may be beneficial for the recovery of cardiac function.Hypoxemia from various causes could be cured after treatment for 2￣4 hours.Conclusions:By monitoring these parameters,it is suggested that BIPAP almost has no effect on blood pressue,and no sideeffect on heart rate as well as respiratory rate.Also,BIPAP ventilation would not result in extra load in circulatory system,and no complications have yet been found by using such method.
出处
《中国危重病急救医学》
CAS
CSCD
1997年第10期611-613,共3页
Chinese Critical Care Medicine
关键词
双相气道正压
压力支持通气
心肺疾病
bilevel positive airway pressure
pressure support ventilation
heart and lung diseases
