摘要
目的探讨双水平正压通气+压力支持通气模式(BiPAP+PSV)改良叹气法在急性呼吸窘迫综合征患者(ARDS)中的临床应用效果。方法将本院收治的36例ARDS患者随机分为试验组和对照组,试验组患者给予BiPAP+PSV改良叹气法通气治疗,对照组患者给予压力支持法(PSV)通气治疗。比较两组患者肺复张前后氧合指数[氧分压/吸入气体氧含量(PaO2/FiO2)]、静态肺顺应性(Cstat)及心率(HR)、中心静脉压(CVP)、平均动脉压(MAP)等血流动力学指标。结果复张前、复张后30分钟、60分钟两组PaO2/FiO2、Cstat差异无统计学意义(P>0.05),复张后120分钟试验组PaO2/FiO2、Cstat显著高于对照组(P<0.05);试验组患者复张后即刻HR、CVP、MAP即开始改善,复张后10分钟恢复原有水平,对照组复张后20分钟才恢复到原有水平。结论与PSV相比,BiPAP+PSV改良叹气法对于ARDS患者复张效果确切,能够显著改善氧合与肺顺应性,且对血流动力学影响较小,值得临床推广应用。
Objective To investigate the effect of bi-level positive airway pressure（BiPAP）＋ pressure support ventilation mode（BiPAP＋PSV） improved sigh method in patients with acute respiratory distress syndrome（ARDS）. Methods Thirty-six ARDS patients admitted to our hospital were randomly divided into experimental group and control group. The patients of experimental group were treated with（BiPAP＋PSV） improved sigh method,and those of control group were given pressure control act （PSV） ventilation. The oxygenation index （PaO2/FiO2 ）, static lung compliance（Cstat） and heart rate（HR）, central venous pressure（CVP）, mean arterial pressure（MAP） of two groups were compared before and after reexpansion. Results There were no significant difference in reexpansion before and 30 min, 60 min after reexpansion in PaO2/FiO2,Cstat（P 〈0.05）; PaO2/FiO2,Cstat of experimental group were significantly higher than those of control group 120 min after reexpansion（ P 〈0.05） ; HR,CVP,MAP of experiment began to improve immediately after reexpansion and the indexes restored the original level 10 min after reexpansion, while those of control group restored to the original level 20 min after reexpansion. Conclusion Compared with PCV, BiPAP＋PSV improved sigh method has exact effect for ARDS patients in reexpansion,which can significantly improve oxygenation and lung compliance, and the method has less impact on hemodynamics, and it is worth clinical application.
出处
《临床荟萃》
CAS
2014年第5期543-546,共4页
Clinical Focus
关键词
呼吸窘迫综合征
成人
呼吸
人工
肺顺应性
血流动力学
respiratory distress syndrome, adult
respiration, artificial
lung compliance
hemodynamics
