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1、机械通气一、机械通气的适应证:1、经积极治疗后病情恶化;2、意识障碍;3、呼吸形式严重异常,如呼吸频率>35~40次/分或<6~8次/分,或呼吸节律异常,或自主呼吸微弱或消失;4、血气分析提示严重通气和/或氧合障碍:PaO2<50mmHg,尤其是充分氧疗后仍<50mmHg;5、PaCO2进行性升高,pH动态下降。二、机械通气的禁忌证:在出现致命性通气和氧合障碍时,机械通气无绝对禁忌症。机械通气的相对禁忌证:1、气胸及纵隔气肿未行引流者;2、肺大疱和肺囊肿;3、低血容量性休克未补充血容量者;4、严重肺出血;5、气管-食管瘘。但在出现致命性通气和氧合障碍时,应在积极处理原发病(
2、如尽快行胸腔闭式引流,积极补充血容量等)的同时,不失时机地应用机械通气,以避免患者因为严重CO2潴留和低氧血症而死亡。因此,机械通气无绝对禁忌症。三、无创通气的适应证地形平坦开阔,地层由第四系全新冲积层,第四系上更新统冲层组成,局部表覆第四系全新统人工堆积层。第四系全新统冲积层厚度约25~50m,岩性主要为黏土、粉质黏土、粉土、粉砂、细砂;第四系上更新统冲积层厚度大于50m,岩性主要为黏性土、粉土、粉细砂等。管桩深度范围内地层主要为:粉土、黏土、粉质黏土,局部表层为杂填土。couplingCentreshallbechecked,thesecondpouredconcret
3、estrengthofmorethan70%.Intheprocessofreamingorboring,apartfromthespecialprovisionsinfactory,doesnotallowanyworkthatmayaffectthecouplingCentre,suchasirrigation,tocylinderconnectionstofloodthecondenserpipesandsoon.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Mountingboltss
4、houldbeaddedlubricants,typinggentlywithasmallhammer,nottoolooseortootight,packedtheboltswiththecorrespondingsealscrewholeshouldbemarked.6.4.5.4.2couplingreamedandpairingsisclosetothediameterofboltbearinggoodhingeholes,dressedwithagoodtwocouplingboltsbeforeyoucanmovetherotor,boring-reamingh
5、oleinturn.Couplingboltsmustbetightcouplingissymmetricaldiameter,inboring,reaming,twoboltsout.Wellboring,hingeboltholeflangewithcouplingofvertical,notoblique.Duetothecouplingboltsinaccordancewithhingeholescorrespondingtothediameterofthescrewholesonebyoneafterprocessing,processingbackboltins
6、tallationlocationcannotbechanged,soaccordingtoboltaftertheactualweightdifferenceofnutandlockwashertomatch.Generalrequirementsforcouplingtwosymmetricaldiameterbolt,nutandlockwasher'stotalweightdifferenceshouldnotbegreaterthan10gandknocksstampedmark.(SeeFigure18)Thecouplingboltsapplylubrican
7、t,andthengentlywithcopperhome,nottoolooseortootight.BoltAssemblyisfinished,symmetricaltighteningallboltsto30%,50%,70%,100%force,andcheckthecouplingflutterandbeforeconnectingthecirclegraduallychangesitsvalueshouldbelessthan0.02mm.Tighteningtorqueofthecouplingbo