机械通气中气道压力增高的原因与防治

The reason for and management of higher airway pressure caused by mechanical ventilation

目的探讨机械通气患者气道压力增高的原因与防治对策。方法对本科2000年1月～2005年8月收治的112例机械通气病例进行回顾性分析。结果发生气道压力增高49例。其原因包括:气道阻塞31例,支气管痉挛7例,肺水肿5例,单肺通气3例,导管受压2例,气胸1例。结论气道阻塞、支气管痉挛、肺水肿为气道压力增高的主要原因。综合防治措施,可防止气道压力增高的发生,提高救治存活率。

Objective To discuss the reason for and management of higher airway pressure caused by mechanical ventilation, Methods 112 cases with mechanical ventilation from January 2000 to August 2005 in our hospital where reviewed retrospectively. Results 49 cases had highly airway pressure. The reasons for high airway pressure included airway obstructs （n =31）, 7 bronchospasm （n= 7）, pneumochysis （n=5）, single lung ventilation （n=3）, pressed catheter （n=2）, and pneumothorax （n= 1）. Conclusion Airway obstruct and bronchospasm and pneumochysis are the main reasons that result in high airway pressure. By enhancing airway management and lowering down airway pressure, high airway pressure can be avoided by adequate respiratory model and ventilation parameter. Thus, it can improve the rate of survival to patient with mechanical ventilator.