摘要
目的探讨成比例辅助机械通气(PAV)对慢性阻塞性肺疾病(COPD)合并高碳酸血症患者呼吸力学的影响。方法在常规药物治疗的基础上,应用无创成比例辅助机械通气(PAV)治疗COPD合并高碳酸血症患者40例,观察并比较不同模式下动脉血气分析指标(PaO2、PaCO2)及呼吸力学变化,包括潮气量(VT)、每分通气量(MV)、呼吸频率(RR)、气道峰压(PIP)和吸气/呼吸周期时间比(Ti/Ttot),并计算平均吸气流速(VT/Ti)。结果COPD合并高碳酸血症患者PAV通气时的RR、PIP和VT/Ti与BiPAP(S/T)相比有显著降低(P<0.05),Ti/Ttotal明显增加(P<0.05),MV有所增加,夜间连续通气时间显著延长。结论与BiPAP相比,无创成比例辅助机械通气(PAV)应用于慢性阻塞性肺病并高碳酸血症患者时气道峰压低、吸气/呼吸周期时间比明显增加,通气依存性好。PAV适宜的辅助比例在40%-60%。
Objective To investigate and compare the effects of proportional pressure support ventilation （PAV） and biphasic positive airway pressure （BiPAP） on respiratory dynamics in COPD patients with hypercapnia. Methods 40 COPD patients with hypercapnia received conventional medical therapy plus BiPAP （S/T） and PAV. BiPAP （S/T） and PAV mode were used in the patients, and respiratory rate （RR）, PaO2, PaCO2, peak inspiratory pressure （PIP）, tidal volume （VT）, minute ventilation （MV）, inspiratory duty cycle （Ti/Tt）, mean inspiratory flow （VT/Ti） and nocturnal ventilation time were measured. Results Compared with BiPAP （S/T） mode under the similar EPAP/CPAP, PIP and VT/Ti were significantly lower（ P〈0.05）, while Ti/Tt was significantly higher （ P〈 ） during PAV, but MV had no significant difference （ P〉0.05）. Conclusion PAV presents lower pressure and higher Ti/Tt in patients with these two modes of ventilation, and noninvasive PAV shows better compliance in COPD patient with hypercapnia. The appropriate assist proportion of PAV is 40% - 60%.
出处
《宁夏医学杂志》
CAS
2007年第6期489-491,共3页
Ningxia Medical Journal
基金
宁夏银川市科技局科技攻关项目(编号:2006061)
