NAVA与PSV两种通气模式下患者舒适度的比较性研究

Comparable Research on Comfort of Patients Treated with NAVA and PSV

目的:将神经调节辅助通气(neurally adjusted ventilatory assist,NAVA)模式与压力支持通气(pressure support ventilation,PSV)模式下患者舒适度进行对比研究。方法:将60例机械通气模式患者随机数字表法分为NAVA组、PSV组各30例。持续机械通气24 h以上,采用《影响机械通气患者舒适情况调查表》进行调查,对两种模式患者均采用镇痛镇静24 h以上(选择同种镇痛镇静药物且相同剂量),应用Riker镇静躁动评分(sedation-agitation scale,SAS)方法进行回顾性调查分析,比较两组患者的舒适情况。结果:NAVA组与PSV组患者在气管插管、吸痰、口干口渴、活动受限等方面比较差异无统计学意义,NAVA组在人机对抗方面低于PSV组(P<0.05)。对两组患者进行镇痛镇静后NAVA组SAS分值低于PSV组,比较差异有统计学意义(P<0.05)。结论:NAVA模式与PSV模式相比,减少了患者因人机对抗带来的不适感,在NAVA模式下患者的躁动程度减轻。该结果表明实施NAVA模式可能是改善患者舒适度的原因。

Objective：To investigate the differences of patients’comfort who were treated with neurally adjusted ventilatory assist （NAVA） or pressure support ventilation （PSV）.Method：Sixty patients treated with mechanical ventilation were randomly divided into two groups.NAVA group and PSV group,and each group consist of 30 cases.Mechanical ventilation continued more than 24 hours,The Impact Mechanical Ventilation Patients Comfortable Situation Questionnaire was used to investigate.Adopted analgesia in patients with two patterns composed more than 24 hours （choose the same analgesic sedative drugs and the same dose）,used Riker sedation - agitation scale （SAS） method for retrospective investigation and analyzed, compared two groups of patients comfortable situation.Result：In patients with NAVA group with PSV endotracheal intubation, sputum suction,dry mouth,thirst,and restricted movement no statistical difference,NAVA group lower incidence of man-machine against PSV（P〈0.05）.After sedation analgesia in patients with two groups of NAVA SAS score was lower than PSV group （P〈0.05）.Conclusion：NAVA mode compared with PSV pattern,reduces the patient discomfort,due to the man-machine confrontation in patients of agitation can alleviate NAVA mode.The result shows that the implementation of NAVA mode may be the cause of improving patient comfort.