慢性阻塞性肺疾病伴呼吸衰竭患者两种通气模式应用效果比较

Effect comparison between two ventilation modes in treatment of chronic obstructive pulmonary disease patients with respiratory failure

目的探讨两种不同呼吸机通气模式对慢性阻塞性肺疾病伴呼吸衰竭患者的影响。方法 85例COPD合并呼吸衰竭患者分为2组,观察组(n=41)患者采用适用性支持通气模式(ASV),对照组(n=44)患者采用压力支持通气模式(PSV)和同步间歇指令通气模式(SIMV)。结果 2组患者HR、呼吸频率、MAP、pH、SpO_2、p(O_2)、p(CO_2)及p(A-a)O_2指标比较无显著差异(P>0.05)。观察组MRV显著高于对照组(P<0.01),潮气量(VT)显著低于对照组(P<0.01)。观察组患者吸气流量显著高于对照组(P<0.01),呼吸比、气道闭合压显著低于对照组(P<0.05)。观察组患者并发症发生率显著低于对照组(P<0.05)。结论相比SIMV+PSV模式,ASV通气模式可以维持COPD伴呼衰患者自主呼吸功能。

Objective To investigate the effects of two ventilation modes on treatment of chronic obstructive pulmonary disease （COPD） patients with respiratory failure. Methods A total of 85 COPD patients with respiratory failure were divided into two groups. The observation group （n = 41 ） was given ASV, while the control group （n = 44 ） was given PSV and SIMV. Results There were no significant differences in HR, respiratory frequency, MAP, pH, SpO2, p（O2）, p（CO2） and p（A-a） 02 between two groups （P 〉0.05）. MRV of observation group was significantly higher than that of control group （ P 〈 0.01 ）, and VT was significantly lower than controls （ P 〈 0.01 ）. Suction flow rate in observation group was significantly higher than that in the control group （P 〈 0.01 ） , and breathing rate, airway closure pressure in observation group were significantly lower than those in the control group （P 〈 0.05 ）. Incidence rate of complications in observation group was sig- nificantly lower than the control group （ P 〈 0.05 ）. Conclusion Compared with SIMV plus PSV model, ASV ventilation model can maintain the spontaneous breathing function of COPD patients with respiratory failure.