不同潮气量不同频率机械通气在瓣膜置换术后病人应用的对比研究

Comparison of the Clinical Research on Different Tidal Volumes and Different Frequency in the Patients with Valve Replacement During Mechanical Ventilation

目的:对比研究10 ml/kg潮气量,10次/min的频率(A参数)和6 ml/kg潮气量16次/min的频率(B参数)持续正压通气在体外循环下瓣膜置换术后病人中的临床应用价值。方法:对100例瓣膜置换术病人术后2 h先后给予A参数和B参数机械通气,记录并比较两种不同参数机械通气1 h后的气道峰压(PIP)、平台压(Pplat)、吸呼比(I:E)的大小,同时比较两种不同参数机械通气对pH值、二氧化碳分压(Pa-CO2)、氧合指数(PaO2/FiO2)的影响。所有数据采用均数±标准差(-x±s)表示,采用Excel 5.0软件进行统计学分析,组间数据用配对t检验,P<0.05表示有统计学意义。结果:PIP、Pplat、pH值、PaO2/FiO2在两种参数下有显著性差异,A参数大于B参数(P<0.05);PaCO2、I:E值A参数小于B参数(P<0.05)。结论:在体外循环下心脏瓣膜置换术后的病人,使用呼吸机机械通气时,给予A参数在氧合面优于B参数。

Objective：To compare the clinical application value of 10 ml/kg tidal volume and 10/minrespiratory frequency（A parameter） with 6 ml/kg tidal volume and 16/min respiratory frequency（B parameter）of continuous positive pressure ventilation in the patients with valve replacement.Methods： 100 cases with valve replacement were included in the study.Patients are first given A parameter continuous positive pressure mechanical ventilation and then are given B Parameter,also record and compare PIP,Pplat,I：E at one hour after ventilation with two different parameter ventilations,At the same time compare the influence of pH,PaCO2,Oxygenation index（PaO2/FIO2）in two different parameter mechanical ventilation.all data are deal with（±s）,statistics analysis deal with Excel 5.0 soft,The data between groups deal with t test,P〈0.05 expeess statistics significant.Results：PIP,Pplat,pH,PaO2/FIO2 following in two parameters have different significantly,A parameter is beyond B parameters（P〈0.05）;The value of PaCO2,I：E in A parameter is less than B parameter（P〈0.05）;Increased following the drop of the tidal volume（P〈0.05）;PaO2/FiO2 of two different tidal Volumes has no significant difference（P〉0.05）.Conclusion：In the patients with Valve replacement of cardiopulmonary bypass during mechanical ventilation,A parameter ventilation is superior to B parameter in Oxygenation.