【摘要】 目的:探讨BIPAP-SIMV-PSV在机械通气时的脱机规律。方法:48例呼吸衰竭患者均采用BIPAP-SIMV-PSV方式脱机,其中18例由于其它原因脱机失败。成功脱机30例,分为短期带机（4～10天）22例,与长期带机（>10天）8例,监测脱机时各参数变化。结果:在吸入氧浓度<40%、低压水平0.39～0.49 kPa（1 kPa=10.2cmH₂O）、PSV一般在低压水平0.49 kPa,可实施脱机过程。短期带机一般使高压水平减至≤1.57 kPa,长期带机高压水平0.98～1.17 kPa,高-低压水平差0.49～1.17 kPa,部分重度肺功能损害患者往往需高压水平接近于低压水平=0.49 kPa完成脱机过程。两组设定呼吸频率4次/分,吸呼比为1:4,两组脱机参数无明显变化（P>0.05）。结论:BIPAP-SIMV-PSV对难以脱机的患者是一种较好的脱机方式。更多还原

【Abstract】 Objective:To investigate the regularity of BIPAP-SIMV-PSV weaning in mechanical ventilation. Methods:Forty-eight patients with respiratory failure underwent BIPAP-SIMV-PSV weaning. Eighteen of them failed in weaning, and 30 were successful which were divided into short-term(4~10 days,22 cases)and long-term ventilation groups(>10 days,8 cases). Results: The weaning process can be carried out under the condition of FiO2 < 40% , low pressure 0.39 ~ 0.49 kPa, and PSV 0.49 kPa. In short-term ventilation,high pressure generally was adjusted less than 1.57 kpa,and the gap between high and low pressure was 0.49~ 1.17 kPa. In some patients with severe lung dysfunction, high pressure was almost equal to low pressure 0.49 kPa for the purpose of successfully completing ventilation. The respiratory frequency was 4 breathes/min, and I:E was 1:4 in two groups.There was no significant difference in weaning between two groups(P>0.05). Conclusion:BI-PAP-SIMV-PSV is a better method for patients with difficult weaning.更多还原