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1、双相气道止压通气与同步间歇指令通气对急性呼吸窘迫综合征的治疗作用［摘要］目的：探讨双相气道正压(BIPAP)通气模式与同步间歇指令通气(SIMV)治疗急性呼吸窘迫综合征(ARDS)的疗效。方法：将26例ARDS患者随机分为BIPAP组和SIMV组行机械通气治疗，每组13例。每种模式通气6h,稳定后分别记录两组的呼吸力学指标(RR、Vte、PIP、Pmean、Crs)、氧动力学指标(PaC02、PaO2、SaO2、PaO2/FiO2)和血流动力学指标(HR、CVP、ABPM)o结果：两组的呼吸力学指标:RR、PIP、P
2、meanBIPAP组低于SIMV组(P<0.05)，而CrsBIPAP组高于SIMV组(P<0.05)；氧动力学指标:Pa02、PaO2/FiO2BIPAP组高于SIMV组(P〈0.05)；血流动力学指标：HR、CVP、ABPM两纟R差异无统计学意义(P>0.05)。结论：BIPAP通气模式人机协同性好，肺损伤小，可改善氧合及呼吸力学效应，治疗ARDS优于SIMV。［关键词］双相气道正压通气；同步间歇指令通气；急性呼吸窘迫综合征［中图分类号］R563.8［文献标识码］A［文章编号11673-7210(2009)01(
3、c)-012-03ThetherapeuticeffectsofbiphasicpositiveairwaypressuremechanicalventilationinpatientswithacuterespiratorydistresssyndromecomparedwithsynchrononsintermittentmandatoryventilationHEHui-jie,WANGHui-min,ZHANGDong,ZHAOGang,WANGChun-na,MAYao(DepartmcntofRespir
4、atoryDisease,theFirstAffiliatedHospitalofBaotouMedicalCollege,Baotou014010,China)［Abstract］Objective:Toexploretheeffectofbiphasicpositiveairwaypressure(BIPAP)mechanicalventilationonpatientswithacuterespiratorydistresssyndrome(ARDS)comparedwithsynchronous(ARDS)i
5、ntermittentmandatoryventilation(SIMV).Methods:Twonty-sixARDSpatientswererandomlydividedintoBIPAPgroupandSIMVgroup,with13patientsineachgroup.Theindexesofrespiratorymechanics(RR,Vte,PIP,PmeanandCrs),oxygenkinetic(PaC02,Pa02,Sa02,PaO2/FiO2)anclhemodynamicparameter
6、s(HR,CVP,ABPM)wererecordedinbothgroupsaftereachmechanicalventilatingforsixhour.Results:RR,PIPandPmeaninBIPAPgroupwerelowerthanthoseinSIMVgroup(P<0.05),butCrsinBIPAPgroupwashigherthanthatinSIMVgroup(P<0.05);Pa02andPa02/Fi02inBIPAPgroupwerehigherthanthoseinSIMVgr
7、oup(P<0.05);HR,CVPandABPMhadnodifferenceintwogroups(P>0.05).Conclusion:BIPAPisaneffectivemodeofmechanicalventilationtherapyforARDSpatients,betterthanSIMV.［Keywords］Biphasicpositiveairwaypressure;Synchronousintermittentmandatoryventilation;Acuterespiratorydistre
8、sssyndrome机械通气是急性呼吸窘迫综合征(acuterespiratorydistresssyndrome,ARDS)的关键性治疗措施，如何正确、恰当地应用机械通气，直接关系到ARDS抢救的成败。然而，长期使用常规通气模式常常引起呼吸机所致肺损伤(vent订ator-inducedlunginjury,V1L1),导致ARDS患者的病死
