摘要
目的:探讨胸腔穿刺抽液对重症监护室机械通气患者的影响。方法:对23例机械通气合并胸腔积液的患者进行胸腔穿刺,比较胸腔穿刺前及穿刺后12 h患者的临床症状、血流动力学、呼吸力学、血气指标的变化。结果:23例患者进行胸腔穿刺后心率下降,平均动脉压上升,但无统计学意义。胸腔穿刺后气道峰压(PIP)较低(0.260±0.013)VS(0.318±0.014)kPa(P<0.05),肺顺应性相对较好(2.53±0.89)VS(2.00±0.57)L/kPa(P<0.05),同时降低了呼吸机做功(2.83±0.35)VS(3.86±0.29)J/L。胸腔积液穿刺后动脉血氧分压、经皮血氧饱合度、氧合指数相对高于胸腔积液穿刺前,但无统计学意义。结论:胸腔穿刺抽液可以使机械通气患者血流动力学稳定,改善气体交换;降低气道峰压,增加肺顺应性,降低呼吸机做功,从而减少呼吸机相关性肺损伤及呼吸机依赖,增加了危重患者的抢救成功率。
Objective：To investigate the effects of thoracocentesis in patients receiving mechanical ventilation with pleural effusion in ICU. Methods：Twenty three patients receiving mechanical ventilation with pleural effusion were studied before and 12 h after thoraeocentesis. Respiratory mechanics,blood gas exchange and the hemodynamics were recorded. Results：The decrease of heat rate and increase of mean arterial pressure after thoracocentesis were observed in all of the patients. Peak inspiratory pressure was significantly lower after thoracocentesis compared with before thoracocentesis（0. 260±0. 013） VS （0. 318 ± 0. 014） kPa （P〈 0.05 ）. Compliance after thoracocentesis was better than before thoracocentesis（2. 53±0. 89 ） VS （2.00±0.57） L/kPa（P〈0.05）. The PaO2 ,SpO2 ,PaO2/fraction of inspired oxygen ratio a{ter thoracocentesis was better than that before thoracocentesis,but it had no statistics significance（P〉0.05）. Conclusions：The stability of hemodynamics and the improvement in pulmonary function after thoracocentesis are observed in patients with pleural effusion. Decrease of peak inspiratory pressure and work performes by the ventilator and the improvement of compliance avoids the ventilator inducing lung injury. The thoracocentesis increases the survival rate of patients with critically ill.
出处
《中国误诊学杂志》
CAS
2010年第9期2019-2020,共2页
Chinese Journal of Misdiagnostics
关键词
穿刺术
胸部
呼吸
人工
重症监护病房
Punctures
Thorax
Respiration, Artificial
Intensive Care Units
