CPAP-PSV与SIMV-PSV-PEEP机械通气模式抢救急性发作重度哮喘患者的效果及预后比较

Comparison of CPAP-PSV and SIMV-PSV-PEEP mechanical ventilation in the treatment of acute exacerbation of severe asthma

目的评价CPAP-PSV模式与SIMV-PSV-PEEP模式抢救急性发作重度哮喘患者的效果及预后。方法选择88例接受机械通气的急性发作重度哮喘患者,随机分为CPAP-PSV方式机械通气组和SIMV-PSV-PEEP方式机械通气组,观察两组患者撤机前30min和撤机后30min的血气分析,有创通气时间、住重症监护室(RICU)时间、呼吸机相关性肺炎(VAP)发生率、撤机成功率等。结果两种通气模式通气后血气变化差异无显著性,CPAP-PSV组通气指标优于SIMV-PSV-PEEP组,采用CPAP-PSV模式早期上机效果好,且脱机率高,住重症监护室时间短。结论病人急性发作重度哮喘患者达到上机后宜尽早行机械通气,采用CPAP-PSV模式上机效果好、且脱机率高。

Objective To evaluate the efficacy and prognosis of CPAP PSV model and SIMV-PSV PEEP model in the treatment of acute exacerbation of severe asthma. Methods 88 patients with acute exacerbation of asthma who were treated with mechanical ventilation were randomly divided into CPAP-PSV mechanical ventilation group and SIMV-PSV PEEP mechanical ventilation group. The blood gas analysis, invasive ventilation time, live intensive care unitfRICU）time, ventilator associated pneumonia（VAP）incidence, weaning success rate and so on were observed in 30 minutes before and after weaning. Results The difference of blood gas analysis in two group was no significant, the ventilation parameters of CPAP-PSV group were better than those of SIMV PSV PEEP group,and there were better effect,higher rate of off line and shorter living time of ICU with CPAP-PSV model used machine on early stage. Conclusion Mechanical ventilation should be used as soon as possible after reaching the machine in the patients with acute exacerbation of asthma,the effect of using machine is good and the rate of off-line is high with CPAP PSV mode.