呼吸机在治疗创伤性颈髓损伤呼吸衰竭中的应用

总结创伤性颈髓损伤合并呼吸衰竭患者使用呼吸机的适应证，比较了CMV及SIMV、正常吸呼比及反比呼吸的血气值、认为在早期宜采用CMV模式及反比呼吸，脱机时应采用间断脱机法，C4及以下水平损伤者脱机前可改用PS法。使用呼吸机的合并症主要有肺部感染、酸碱及水电解质平衡紊乱、气道阻塞等。

The utlization of respirator in the management of respiratory of patients with acute cervical spinal cord injury

The indication of using respirator, the selection of ventilation mode, the parameter preset,complications and the indication as well as the mode of ending mechanical ventilation were summarized based on the patients with acute cervical spinal cord injury admitted into ICU in the hospital. The blood gas changes were separately analyzed in using normal ratio of breathing,inverse ratio ventilation,control mechanical ventilation and synchronized intermittent mandatory ventilation. The investigation showed that it was much better to use control mechanical ventilation and inverse ratio ventilation during actue stage of cervical spinal cord injury. When the mechanical ventilation stopped,the intermittent off-line operation would be more beneficial to the patients. In patients with injury level below C.,the progressive off-line operation might partially support with mechanical ventilation. The complications of mechanical ventilation were obstruction of the air-way, atelectasis, pneumonia, respiratory alkalosis and hyponatrimia.