摘要
目的 探讨BiPAP -S/T -D30通气支持系统的临床应用方法及其效果。方法 对通气效果及其对呼吸功能的影响、该系统配件方便呼气孔与碟式呼气活瓣在不同支持压力水平对CO2 排出量的影响、通气支持与使用呼吸兴奋剂的关系进行了观察。结果 通气后PaCO2 下降 1 0 8kPa(P <0 0 1) ,PaO2 升高 2 2 1kPa(P <0 0 0 1) ;呼吸频率下降 (P <0 0 1) ,潮气量、吸气峰值流速和指端血氧饱合度明显增加 (P <0 0 5 ) ,平均吸气流速即潮气量与吸气时间比略下降但无明显统计学差异(P >0 0 5 )。方便式呼气孔与碟式呼气活瓣在低于 10cmH2 O和大于 2 0cmH2 O支持压力时二者对动脉血二氧化碳影响无明显统计学差异 (P >0 0 5 ) ,而 10～ 15cmH2 O压力支持时使用碟式呼气活瓣的效果明显优于方便式呼气孔 (P <0 0 0 1) ;并用呼吸兴奋剂能改善病人的意识状态 ,提高使用BiPAP呼吸的顺从性。结论 合理选用碟式呼气活瓣 ,适当加用呼吸兴奋剂可提高通气改善的效果和使用呼吸机的顺从性。
Objective To discuse the application and effects of BiPAP S/T-D 30 ventilatory support system Method The effects on the rispiratory function and the change of end expiratory CO 2 with disposable value,and the relationship between exhalation value,and the relationship between ventilatory support and respiratory centre active drugs infusion were observed.Result After ventilation PaCO 2 reduced 1.08 kPa(p<0 001),PaO 2 increased 2.21 kPa( P <0 001)respiratory rat reduced( P <0 01),tidol volume and everage inspiratory flow remarkably increased( P <0 01, P <0 05)and the ratiol of tidol volume to the time of inspiration was not changed( P >0 05) The effect on exhalation of CO 2 was nosinificance different with disposable exhalation port or plateau exhalation value at below 10 cmH 2O and over 20 cmH 2 support pressure,but remarkable different in the range of 10 cmH 2O to 15 cmH 2O combinded ventilation support with respiratory centre active drugs could impprove the mental status of patients and vetilation effect.Conclusion Selectting and using rationally plateau exhalation valve and respiratory centre active drugs can get much better results when use the BiPAP S/T-D30 ventilatory support system,and enhance the contract function of respiratory muscles. [
出处
《中国急救医学》
CAS
CSCD
北大核心
2000年第3期144-145,共2页
Chinese Journal of Critical Care Medicine
