P_(0.1)在评估卒中相关性肺炎机械通气患者脱机中的应用价值

Significance of P_(0.1) in evaluating indication for weaning in patients with stroke-associated pneumonia undergoing mechanical ventilation

目的探讨气道闭合压(P0.1)在评估卒中相关性肺炎(SAP)机械通气患者脱机时的应用价值。方法机械通气SAP患者46例,按P0.1结果将其分为P0.1正常(A组,27例)和P0.1异常(B组,19例)。比较两组气道峰压(Ppeak)、潮气量(VT)、呼吸频率(RR)、脉搏血氧饱和度(SpO2)、自主呼吸测试通过率和机械通气时间。结果与B组比较,A组机械通气时间短,自主呼吸测试通过率高,Ppeak低,VT大,SpO2高(P<0.05)。患者VT与P0.1呈曲线拟合关系(校正R2=0.7753,F=173.4787,P<0.05)。结论 P0.1能反映SAP患者呼吸中枢驱动力的大小,可用于临床指导机械通气患者脱机时机的选择。

Objective To explore the significance of airway occlusion pressure at 0. 1 s（P0.1 ） in evaluating the weaning indication in the patients with stroke-associated pneumonia（SAP） undergoing mechanical ventilation. Methods A total of 46 SAP patients undergoing mechanical ventilation was divided into two groups of A（with normal P0.1,27 cases） and B（with abnormal P0.1,19 cases）. The peak airway pressure （ Ppeak）, tidal volume （ VT ）, respiratory rate （RR）, pulse oxygen saturation （SpOz）, pass rate of spontaneous breathing test and mechanical ventilation time were compared between two groups. Results Compared with group B, the patients in group A had shorter mechanical ventilation time, higher pass rate of spontaneous breathing test, lower Ppeak, larger VT and higher SpO2 （P〈0. 05）. The VT and P0.1 had a curve fitting relationship （adjusted RZ=0. 7753, F=173. 4787,P〈0. 05）. Conclusion P0.1 can reflect the driving power of the respiratory center in SAP patients and can be taken as an indicator for the weaning from mechanical ventilation.