新型智能通气模式对急性呼吸窘迫综合征患者临床呼吸力学的影响

Effects of a new intelligent ventilation mode on clinical respiratory mechanics in patients with acute respiratory distress syndrome

目的:探讨新型智能通气模式对急性呼吸窘迫综合征(ARDS)患者临床呼吸力学的影响。方法:84例ARDS患者根据简单随机数表法分为观察组(42例)与对照组(42例)。观察组采用新型智能通气模式(智能触发+自适应分钟通气)治疗,对照组采用传统通气模式(同步间歇指令+压力支持通气)治疗。比较两组患者的机械通气相关指标、呼吸力学指标及血气指标。结果:观察组通气时间、人工操作次数、呼吸机报警次数、机械能均少于对照组(P<0.05)。两组患者通气后呼吸频率、分钟通气量、肺静态顺应性较通气前上升,气道峰值、气道闭合压较通气前下降(P<0.05);观察组通气后呼吸频率、肺静态顺应性显著高于对照组(P<0.05),观察组分钟通气量、气道峰值、气道闭合压与对照组比较,差异无统计学意义(P>0.05)。两组患者通气后pH值与通气前比较,差异无统计学意义(P>0.05),两组患者通气后PaO_(2)高于通气前,PaCO_(2)低于通气前(P<0.05);观察组通气后pH值、PaO_(2)与对照组比较,差异无统计学意义(P>0.05);观察组通气后PaCO_(2)显著低于对照组(P<0.05)。结论:新型智能通气模式用于ARDS治疗可缩短通气时间,降低机械能,减少医护工作量,而且能有效改善患者血气指标和呼吸力学指标,保护肺功能。

Objective To explore the effects of a new intelligent ventilation mode on clinical respiratory mechanics in patients with acute respiratory distress syndrome(ARDS).Methods A total of 84 patients with ARDS were divided into observation group(42 cases)and control group(42 cases)according to the simple random number table method.New intelligent ventilation mode(intelligent trigger+adaptive minute ventilation)was adopted in observation group,and conventional ventilation mode(synchronous intermittent command+pressure support ventilation)in control group.The mechanical ventilation-related indexes,respiratory mechanics indexes and blood gas indexes were compared between two groups.Results The ventilation time,manual operation frequency,ventilator alarm frequency and mechanical energy in observation group were less than those in control group(P<0.05).After ventilation,the respiratory rate,minute ventilation and static lung compliance of two groups of patients were increased;and there were drops in peak airway and airway closure pressure(P<0.05).The respiratory frequency and static lung compliance of observation group after ventilation were significantly higher than those of control group(P<0.05),but there was no statistically significant difference between two groups in minute ventilation,airway peak and airway closure pressure(P>0.05).The pH of two groups of patients after ventilation was close to that before ventilation(P>0.05).After ventilation,PaO_(2) of two groups of patients was higher than that before ventilation,and PaCO_(2) was lower(P<0.05);and the differences between two groups in pH and PaO_(2) after ventilation were trivial(P>0.05);and the PaCO_(2) of observation group after ventilation was significantly lower than that of control group(P<0.05).Conclusion The new intelligent ventilation mode used in the treatment of ARDS can shorten ventilation time,reduce mechanical energy and lessen the workload of medical care.Moreover,it can effectively improve the blood gas index and respiratory mechanics index of patients,and protect the lung function.