急性呼吸窘迫综合征绵羊模型吸气相动静态肺压力容积曲线曲折点的应用研究

Judging and Application of Point-Inflection on Dynamic and Static Pressure Volume Curve in Acute Respiratory Distress Syndrome Sheep Model

目的：探讨吸气相动态及静态压力容积（Ｐ－Ｖ）线曲折点的相关性和应用价值。方法：比较绵羊急性呼吸窘迫综合征（ＡＲＤＳ）模型，在呼气末正压（ＰＥＥＰ）为０ ｋＰａ（ＺＥＥＰ）、静态 Ｐ－Ｖ曲线曲折点对应压力作为 ＰＥＥＰ（曲折点ＰＥＥＰ及曲折点ＰＥＥＰ－０．２９４ｋＰａ和曲折点ＰＥＥＰ个０．２９４ ｋＰａ时的动静态Ｐ－Ｖ曲线曲折点的存在及相关性。结果：在不同水平的ＰＥＥＰ条件下，曲折点压力、容积及Ｓｂ／Ｓａ间均有很好的相关性（Ｐ＜０．０５）。结论：在绵羊ＡＲＤＳ模型中，动静态Ｐ－Ｖ曲线曲折点有很好的相关性，可较好地对肺泡复张程度进行量化测量，使判定最佳ＰＥＥＰ的方法更加方便简捷。

To find the judging method and correlation of point-inflection on static and dynamic pressure-volume(P-V) curve. Method:The exist state of point-inflection were compared at different PEEP levels including zero PEEP,minimal pre- ssure which made the point-inflection disappeared (inflection- PEEP ), inflection- PEEP - 0. 294kPa (3cm H_2O ), and inflec- tion-PEEP + 0.294 kPa(3 cm H_2 O). Results:On ARDS sheep model, dynamic and static P-V curve, Sb/Sa,pressure inflec- tion,and volume-inflection had very good correlation(P<0.05). Conclusion: It is more convenient and correct using dynam- ic point-inflection to stead static point-inflection and to judge the state of alveoli recruitment.