呼气末正压通气对急性呼吸窘迫综合征患者血液动力学的影响

Effect of PEEP for ARDS patients' hemodynamics

目的探讨机械通气过程中,呼气末正压通气(PEEP)对急性呼吸窘迫综合征(ARDS)患者血液动力学的影响。方法选择血液动力学稳定、诊断为ARDS的患者10例,APACHEⅡ评分13～25分,年龄25～65岁,采用自身前后对照,分为PEEP调整前组和PEEP调整后组,分别记录PEEP下调至4 mmHg前后的CVP、HR、MAP。结果 PEEP调整前组CVP值明显高于PEEP调整后组(P<0.05),HR与MAP指标差异无统计学意义(P>0.05)。结论 ARDS患者于呼吸机辅助通气模式下,下调PEEP可以导致CVP的下降,而对于心率和平均动脉压则影响较小。

【Objective】 To detect the effect of PEEP for ARDS patients＇ hemodynamics.【Methods】 10 ARDS patients aged 25 - 65 yr whose hemodynamics were stable were chosen in the trial,the APACHE Ⅱ score ranged from 13 to 25.CVP,HR and MAP of each patient were recorded after decreasing 4 mmHg of PEEP with self-control.【Results】 The CVP were significant different with PEEP adjusting（P 0.05）,there were no significant difference of HR and MAP when PEEP was adjusted（P 0.05）.【Conclusion】 Decreasing PEEP may result in the decreasing of CVP,but it has little effect for HR and MAP in ARDS patients with mechanical ventilation.