不同机械通气模式对COPD合并呼吸衰竭患者氧代谢指数及血气分析的影响

Effects of Different Mechanical Ventilation Modes on Oxygen Metabolism Index and Blood Gas Analysis in Patients with COPD Complicated with Respiratory Failure

目的探讨不同机械通气模式对COPD合并呼吸衰竭患者氧代谢指数及血气分析的影响。方法选取2016年5月~2017年12月我院收治的COPD合并呼吸衰竭患者60例,采用随机数字表法分为观察组和对照组,每组30例。两组均行呼吸机支持呼吸,观察组给予适应性压力支持(ASV),对照组给予同步间歇指令性通气(SIMV)+压力支持通气(PSV),比较两组治疗开始即刻和治疗后6 d呼吸频率、氧代谢指数、血气分析。结果治疗后,两组PaO2、pH高于治疗前,PaCO2、RR低于治疗前,且观察组PaO2、PaCO2、RR、pH优于对照组,差异有统计学意义(P<0.05)。两组CaO2、DO2、SaO2高于治疗前,VO2低于治疗前,且观察组CaO2、VO2、DO2、SaO2优于对照组,差异有统计学意义(P<0.05)。结论ASV模式在COPD急性加重合并呼吸衰竭患者中有助于提升肺通气功能、促进自主呼吸回复,改善机体氧供需平衡,具有较好的效果,优于SIMV+PSV模式。

Objective To investigate the effects of different mechanical ventilation modes on oxygen metabolism index and blood gas analysis in patients with COPD complicated with respiratory failure.Methods 60 patients with COPD and respiratory failure admitted to our hospital from May 2016 to December 2017 were enrolled.The patients were divided into observation group and control group by random number table,30 cases in each group.The ventilator supported breathing in both groups,the observation group was given adaptive pressure support(ASV),and the control group was given synchronous intermittent mandatory ventilation(SIMV)+pressure support ventilation(PSV).The two groups were compared immediately after treatment and 6 days after treatment.Respiratory rate,oxygen metabolism index,blood gas analysis.Results After treatment,the PaO2 and pH of the two groups were higher than those before treatment,and the PaCO2 and RR were lower than those before treatment,and the PaO2,PaCO2,RR and pH of the observation group were better than the control group,the difference was statistically significant(P<0.05).The CaO2,DO2 and SaO2 in the two groups were higher than those before treatment,and the VO2 was lower than that before treatment,and the CaO2,VO2,DO2 and SaO2 in the observation group were better than the control group,the difference was statistically significant(P<0.05).Conclusion ASV mode is helpful in improving pulmonary ventilation function,promoting spontaneous respiratory recovery,improving oxygen supply and demand balance in patients with acute exacerbation of COPD,and has better effect than SIMV+PSV mode.