摘要
目的对比平均容积保证压力支持(AVAPS)与无创人机协调通气(NIV-PSV)模式在机械通气脱机困难患者中的应用效果。方法本研究采用前瞻性随机对照分析,抽取2020年1月至2022年3月新密市中医院收治的86例机械通气脱机困难者为研究对象,根据随机数字表法分为观察组与对照组,每组43例。两组患者均给予常规治疗,对照组在此基础上给予NIV-PSV模式治疗,观察组给予AVAPS模式治疗。比较两组患者脱机成功情况、死腔通气量和潮气量的比值(VD/VT)、重症监护室(ICU)住院时间,比较通气前及通气治疗24 h后的动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、舒张压、收缩压、用力肺活量(FVC)、呼气高峰流量(PEFR)。结果观察组脱机成功率(69.77%,30/43)高于对照组(88.37%,38/43),P<0.05。通气治疗前,两组血气指标、肺功能指标、血压、ESS评分比较差异未见统计学意义(P>0.05);通气治疗24 h后,观察组FVC、PaO_(2)及PEFR高于对照组,PaCO_(2)、舒张压、收缩压低于对照组(P<0.05)。观察组DD/VT值与ICU住院时间低于对照组(P<0.05)。结论相较于NIV-PSV模式,AVAPS通气模式可以提高机械通气脱机困难患者的脱机成功率,有效改善患者的通气效率、血气指标、肺功能及血压。
Objective To compare the application effects of average volume assurance pressure support(AVAPS)and non-invasive patient-ventilator synchrony ventilation(NIV-PSV)in patients with difficulty in weaning from mechanical ventilation.Methods A prospective randomized controlled analysis was used in this study.Eighty-six patients with difficulty in weaning from mechanical ventilation who were admitted to Xinmi Hospital of Traditional Chinese Medicine from January 2020 to March 2022 were included as the research objects.According to the random number table method,they were divided into observation group and control group,with 43 patients in each group.Both groups of patients were given routine treatment;in addition,the control group was given NIV-PSV mode treatment,and the observation group was given AVAPS mode treatment.The success of weaning,dead space volume/tidal volume(VD/VT),length of stay in intensive care unit(ICU)were compared between the two groups.The arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),diastolic pressure,systolic pressure,forced vital capacity(FVC),and peak expiratory flow rate(PEFR)before and 24 hours after ventilation were compared between the two groups.Results The success rate of weaning of the observation group(69.77%,30/43)was higher than that of the control group(88.37%,38/43),P<0.05.There was no statistical significant difference in blood gas indexes,pulmonary function indexes,blood pressure and ESS score between the two groups before ventilation treatment(P>0.05).After 24 hours of ventilation treatment,FVC,PaO_(2)and PEFR in the observation group were significantly higher than those in the control group,while PaCO_(2),diastolic blood pressure and systolic blood pressure were significantly lower than those in the control group(P<0.05).The DD/VT value and length of stay in ICU in the observation group were significantly lower than those in the control group(P<0.05).Conclusions Compared with NIV-PSV ventilation mode,AVAPS ventilation mode has a better effect in patients with difficulty in weaning from mechanical ventilation.It can improve the success rate of weaning,and effectively improve the ventilation efficiency,blood gas indexes,pulmonary function and blood pressure of patients.
作者
赵艳琳
高丽晓
Zhao Yanlin;Gao Lixiao(Xinmi Hospital of Traditional Chinese Medicine,Xinmi 452370,China;Dengfeng People’s Hospital,Dengfeng 452470,China)
出处
《中国实用医刊》
2023年第7期69-72,共4页
Chinese Journal of Practical Medicine
关键词
机械通气
脱机困难
无创人机协调通气
平均容积保证压力支持
Ventilators,mechanical
Difficulty in weaning from mechanincal ventilation
Non-invasive patient-ventilator synchrony ventilation
Average volume assurance pressure support
作者简介
通信作者:赵艳琳,Email:zhaoyanling1977z@163.com
