不同通气模式对慢性阻塞性肺疾病患者机械通气撤机过程的应用比较

Application of different ventilation modes for weaning in COPD patients under mechanical ventilation

目的观察并比较压力支持通气(Pressure support ventilation,PSV)和适应性支持通气(Adaptive support ventilation,ASV)两种通气模式对慢性阻塞性肺疾病(简称慢阻肺)患者机械通气撤机过程的影响。方法将83例慢阻肺患者随机分为两组,对照组(n=41)患者采用ASV通气模式,观察组(n=42)采用PSV通气模式;比较两组患者的临床优劣性和实用性。结果两组患者撤机前后的血气分析无显著变化(P>0.05);两组患者的撤机成功率、撤机失败率、重新插管率以及撤机时间均无显著差异(P>0.05);两组均未发现临床水平呼吸机相关肺损伤情况。结论 PSV和ASV在慢阻肺患者机械通气中有着较为相近的撤机成功率,临床效果无显著区别,且可以在一定程度降低呼吸负荷、保护肺组织,均能够较好地应用于临床。

Objective To observe and compare the influence of PSV and ASV on weaning from mechanical ventilation of in COPD patients. Methods 83 COPD patients were randomly divided into two groups. The control group （n=41） received the ventilation mode of ASV, and the observation group （n=42） received the ventilation mode of PSV. The clinical advantages and disadvantages and practicability of the two groups were compared. Results There was no evident difference in blood gas analysis before and after extubation between the two groups （ P 〉0. 05）. There was no significant difference in the success rate of extubation, the failure rate of extubation, the rate of repositioning and weaning time between the two groups （ P〉0. 05 ） . There was no lung injury occurred in the two groups. Conclusion PSV and ASV has similar success rate of extubation in mechanical ventilation of COPD pa-tients, and there is no evident difference for clinical effect between the two methods, which both can reduce respirato-ry load and protect lung tissue.