胸腔积液对机械通气患者呼吸功能和血流动力学的影响

The Effect of Pleural Effusion to Respiratory Function and Hemodynamics in Mechanical Ventilation Patients

目的探讨胸腔积液对机械通气危重患者呼吸功能及血流动力学的影响。方法对40例机械通气并发胸腔积液的危重患者,比较胸腔积液引流前及引流24 h 后动脉血气、呼吸力学及血流动力学参数的变化。结果胸腔积液引流后动脉血氧分压(PaO_2)、氧合指数(PaO_2/FiO_2)、动脉血二氧化碳分压(PaCO_2)及肺泡动脉血氧分压差(A-aDO_2)较引流前均有明显改善,P 均<0.05;胸腔积液引流后潮气量(Vt)、气道峰压(Ppeak)、平台压(Ppause)、心率(HR)、中心静脉压(CVP)、平均动脉压(MAP)较引流前均有明显改善(P 均<0.05)。结论机械通气危重患者引流胸腔积液可以明显改善通气和换气功能,并使患者的血流动力学趋于稳定。

Objective To investigate the effect of pleural effusion to respiratory function and hemodynamics in mechanical ventilation patients. Methods To compare the artery blood gas parameters of respiratory mechanics and hemodynamies parameters, 40 eases of mechanical ventilation severe patients before drainage and 24 hours after drainage of pleural effusion was analyzed. Results After drainage PaO2（ P 〈0.01） ,PaO2/FiO2（ P 〈0.05） ,PaCO2（ P 〈0.01） ,A-aDO2（ P 〈0. 05）was improved significantly,and VT（ P 〈0.05）,Ppeak（ P 〈0.01）,Ppause（ P 〈0.05）,HR（ P 〈0.01）, CVP （ P 〈 0.05 ） and MAP（ P 〈 0. 05 ）were better than before drainage. Conclusion The function of ventilation, gas exchange, hemodynamics and prognosis of MV severe patient could be significantly improved through the drainage of the pleural effusion.