适应性支持通气模式对老年呼吸衰竭患者呼吸力学及动脉血气的影响

Effects of Adaptive Support Ventilation on Respiratory Mechanics and Arterial Blood Gas in Elderly Patients with Respiratory Failure

目的:观察适应性支持通气(ASV)模式对老年呼吸衰竭患者呼吸力学及动脉血气的影响。方法:选取本院收治的77例行机械通气治疗的老年呼吸衰竭患者,根据不同机械通气治疗方案将其分为对照组(n=37)和观察组(n=40)。对照组采用同步间歇指令通气(SIMV)+压力支持通气(PSV)机械通气治疗方案,观察组采用ASV机械通气治疗方案。比较两组呼吸机撤除成功率、机械通气治疗总时间、机械通气治疗期间呼吸力学及动脉血气相关指标。结果:观察组、对照组呼吸机撤除成功率分别为82.5%(33/40)、81.1%(30/37),比较差异无统计学意义(P>0.05);观察组机械通气治疗总时间(12.5±3.1)d,明显短于对照组的(15.7±3.5)d,比较差异有统计学意义(P<0.05);两组每分钟通气量(MV)比较差异无统计学意义(P>0.05);观察组呼吸频率(f)、气道峰压(Ppeak)、平均气道压(Pmean)、气道平台压(Pplat)、吸气阻力(Rinsp)、呼气阻力(Rexp)均明显低于对照组,潮气量(VT)明显高于对照组,比较差异均有统计学意义(P<0.05);两组机械通气治疗期间动脉血气相关指标比较差异无统计学意义(P>0.05)。结论:ASV模式不但可改善老年呼吸衰竭患者呼吸力学相关指标,还具有较高的安全性,值得临床推广应用。

Objective:To observe the effect of adaptive support ventilation(ASV)on respiratory mechanics and arterial blood gas in elderly patients with respiratory failure.Method:A total of 77 elderly patients with respiratory failure treated by mechanical ventilation in our hospital were selected.According to different mechanical ventilation treatments,they were divided into control group(n=37)and observation group(n=40).The control group was treated with simultaneous intermittent mandatory ventilation(SIMV)+pressure support ventilation(PSV)mechanical ventilation,while the observation group was treated with ASV mechanical ventilation.The success rate of ventilator withdrawal,total time of mechanical ventilation,respiratory mechanics and arterial blood gas related indexes during mechanical ventilationbetweentwo groups were compared.Result:The success rate of ventilator removal in observation group and control group was 82.5%(33/40)and 81.1%(30/37)respectively,the difference was not statistically significant(P>0.05).The total time of mechanical ventilation inobservation group(12.5±3.1)d was significantly less than(15.7±3.5)d of control group,the difference was statistically significant(P<0.05).Theventilation volume per minute(MV)between two groups was compared,the difference was not statistically significant(P>0.05).The respiratory rate(f),airway peak pressure(Ppeak),mean airway pressure(Pmean),plateau airway pressure(Pplat),inspiratory resistance(Rinsp),and expiratory resistance(Rexp)in observation group were significantly lower than those of control group,and tidal volume(VT)was significantly higher than that of control group(P<0.05).The arterial blood gas indexes between two groups during mechanical ventilation treatment was compared,the difference was not statistically significant(P>0.05).Conclusion:ASV model can not only improve the respiratory mechanics of elderly patients with respiratory failure related indicators,but also has high safety,worthy of clinical application.