肺源性和非肺源性急性呼吸窘迫综合征早期的顺应性及呼吸功比较

目的观察肺源性和非肺源性急性呼吸窘迫综合征（ARDS）早期病人应用不同水平呼气末正压（PEEP）时静态呼吸系统总顺应性以及呼吸功的差异。方法将22例ARDS患者分为肺源性ARDS组（ARDSp，10例）和非肺源性ARDS组（ARDSexp，12例）。通过肺监测仪和呼吸机记录食道压变化值（△Peso）、平台压、呼气末压力、呼吸功，通过公式计算静态呼吸系统总顺应性的数值。结果随着PEEP水平的提高，两种原因ARDS的呼吸功均增大；ARDSp的呼吸功大于ARDSexp，除了在15cmH2O水平：在不同PEEP水平时，ARDSp和ARDSexp的静态呼吸系统总顺应性差异无统计学意义。结论ARDSp的呼吸功大于ARDSexp，两者的呼吸系统总顺应性差异无显著性。

Comparison of respiratory compliance and work of breathing between pulmonary ARDS and extrapulmonary ARDS in the early phase

Objective To observe the differences in static compliance of respiratory system and examine the different effect on the work of breathing with various PEEP levels between pulmonary ARDS（ARDSp） and extrapulmonary ARDS（ARDSexp） in the early phase. Methods 10 ARDSp patients and 12 ARDSexp patients using ventilation with four different PEEP levels were selected. Delta esophageal pressure（APeso）, Platform pressure, end-expiratory pressure, the work of breathing were measured and recorded： Static compliance of respiratory system was computed by formulation. Results As PEEP was increased from 0 to 15 cmH2O, the work of breathing increased. On the same levels of PEEP, the work of breath in ARDSp was higher than in ARDSexp. There are no statistical difference in static compliance of respiratory system. Conclusion The work of breathing in ARDSp is higher than ARDSexp, but no significant difference in static compliance of respiratory system in ARDSp and ARDSexp.