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压力和容量控制通气治疗急性呼吸窘迫综合征的比较性研究

Study of treatment in patients with acute respiratory distress syndrome by pressure and volume control ventilation

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【作者】 徐思成黄亦芬董旭南王在义

【Author】 XU Si cheng, HUANG Yi fen, DONG Xu nan, et al (Department of Respirology,First Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, China)

【机构】 新疆医科大学第一附属医院呼吸科新疆医科大学第一附属医院急救中心新疆医科大学第一附属医院ICU 新疆乌鲁木齐830054新疆乌鲁木齐830054新疆乌鲁木齐830054

【摘要】 目的:探讨压力控制通气 (PCV )和容量控制通气 (VCV )对呼吸力学和氧合作用的影响。 方法:对 2 0例急性呼吸窘迫综合征 (ARDS)患者进行机械通气 (MV )治疗。A组先用 PCV,分别保持潮气量 (VT)和平均气道压(MPaw)不变 ,后改为 VCV;B组先用 VCV ,后改为 PCV,保持血氧饱和度平稳 0 .5 h后监测指标。受试者在 5 h内依次完成上述实验。 结果 :PCV时峰压 (PIP)、平台压 (Pplat)明显低于 VCV时的 PIP、Pplat(P均 <0 .0 1) ,而 MPaw明显高于 VCV时的 MPaw(P <0 .0 1) ;在保持 MPaw相同时 ,氧合作用差异无统计学意义 (P >0 .0 5 ) ,患者均无气压伤。 结论 :PCV可以有效地控制 PIP、Pplat,并保证氧合 ,实现肺保护性通气。

【Abstract】 Objective: To assess the effects on respiratory mechanics and oxygenation in treatment of patients with acute respiratory distress syndrome (ARDS) by pressure control ventilation (PCV) and volume control ventilation (VCV). Methods: 20 patients with ARDS were treated by mechanical ventilation. Ten patients (group A) first took PCV, remaining constant tidal volume (V\-T) and mean airway pressure (MP aw ) respectively; while the other 10 patients (group B) took the reverse turn. SaO\-2 should keep stable for at least half an hour before monitoring index. Trials should be complete during 5hs. Results: Peak inspiration pressure (PIP) and plateau pressure(P plat ) in PCV were obviously lower than those in VCV (P all <0.01) , while MP aw was obviously higher than that in VCV(P<0.01). Keeping MP aw constant, blood oxygenation had no distinction between PCV and VCV (P>0.05). All patients showed no ventilator induced lung injury. Conclusion: PCV can effectively control PIP?P plat , ensure blood oxygenation and carry out lung protected ventilation.

  • 【文献出处】 新疆医科大学学报 ,Journal of Xinjiang Medical University , 编辑部邮箱 ,2003年01期
  • 【分类号】R563.8
  • 【被引频次】4
  • 【下载频次】60
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