适应性支持通气在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者治疗中的价值分析

The Value of Adaptive Support Ventilation in Treatment of Patients with Chronic Obstructive Pulmonary Disease Complicated with Type Ⅱ Respiratory Failure

目的:分析适应性支持通气(ASV)在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者治疗中的临床价值。方法:选取94例COPD合并Ⅱ型呼吸衰竭患者,根据治疗方法不同分为SIMV组(SIMV通气模式治疗)和ASV组(ASV通气模式治疗),各47例。比较两组呼吸频率(RR)、潮气量(TV)、吸气峰值压(PIP)、分钟通气量(MV)等呼吸机相关参数,中心静脉压(CVP)、心率(HR)、收缩压(SBP)、舒张压(DBP)等外周血循环指标,动脉氧分压(PaO_2)、pH、血氧饱和度(SaO_2)及动脉二氧化碳分压(PaCO_2)等动脉血气指标。结果:两组MV比较差异无统计学意义(P>0.05),ASV组RR、TV、PIP均明显低于SIMV组(P<0.05);ASV组HR、SBP、DBP、CVP均低于SIMV组(P<0.05);两组PaCO_2比较差异无统计学意义(P>0.05),ASV组PaO_2、SaO_2、pH均高于SIMV组(P<0.05)。结论:ASV机械通气治疗模式较SIMV可明显改善COPD合并Ⅱ型呼吸衰竭患者呼吸机相关参数、外周血循环及动脉血气指标。

Objective:To analyze the clinical value of adaptive support ventilation(ASV)in treatment of patients with chronic obstructive pulmonary disease(COPD)complicated with typeⅡrespiratory failure.Method:A total of 47 patients with COPD complicated with typeⅡrespiratory failure were selected,according to the different treatment methods,they were divided into SIMV group(SIMV ventilation mode treatment)and ASV group(ASV ventilation mode treatment),47 cases in each group.The ventilator parameters such as respiratory frequency(RR),tidal volume(TV),peak pressure(PIP),minute ventilation(MV),the indexes of peripheral blood circulation such as central venous pressure(CVP),heart rate(HR),systolic pressure(SBP),diastolic pressure(DBP),and the indexes of arterial blood gas such as arterial oxygen pressure(PaO2),pH,blood oxygen saturation(SaO2)and arterial carbon dioxide partial pressure(PaCO2)in two groups were compared.Result:The MV in two groups was compared,the difference was not statistically significant(P>0.05),the RR,TV and PIP of ASV group were significantly lower than those of SIMV group(P<0.05).The HR,SBP,DBP and CVP of ASV group were lower than those of SIMV group(P<0.05).The PaCO2 in two groups was compared,the difference was not statistically significant(P>0.05),the PaO2,SaO2 and pH of ASV group were higher than those of SIMV group(P<0.05).Conclusion:Compared with SIMV,ASV mechanical ventilation can significantly improve ventilator-related parameters,peripheral blood circulation and arterial blood gas index in COPD patients complicated with typeⅡrespiratory failure.