机械通气患者进行呼吸力学监测的临床意义

目的 探讨呼吸力学监测指导机械通气参数调节的临床意义.方法 纳入2014年1月至2015年12月入住RICU行有创机械通气的呼吸衰竭患者,随机选择进行有创机械通气患者60例,设为呼吸力学监测组,给予该组患者进行呼吸力学监测(监测参数包括气道阻力、顺应性、平台压、跨肺压等),根据监测指标指导其机械通气参数的调节;随机选择进行有创机械通气患者53例,设为对照组,该组患者按照经验进行机械通气参数设置和调节;统计两组机械通气患者的机械通气时间、住RICU时间和气压伤的发生率.结果 与按经验进行机械通气设置的患者相比,进行呼吸力学监测指导机械通气的患者机械通气时间(6.40±0.82)d vs (5.20±0.63)d(P＜0.05)及住RICU时间(10.49土1.32)d vs (8.83±0.88)d(P＜0.05)缩短,气压伤的发生率下降(11.32％ vs 3.33％,P＜0.01).结论 常规对有创机械通气患者进行呼吸力学监测可以缩短机械通气时间和住RICU时间,提高机械通气的安全性.

Clinical significance of mechanical ventilation with respiratory mechanics monitor

Objective To investigate the clinical significance of respiratory mechanics monitor in mechanical ventilation.Methods Patients with invasive mechanical ventilation in our Respiratory Intensive Care Unit (RICU) from January 2014 to December 2015 were enrolled.60 patients were randomly selected as respiratory mechanics group,monitored their respiratory mechanics (include airway resistance,compliance,Pplateau and transpulmonary pressure) to guide the mechanical ventilation parameter adjustment.53 patients were randomly selected as control group and their mechanical ventilation parameter adjusted according to the experience.Their days of mechanical ventilation,RICU length of stay and the incidence of barotraumas were counted.Results Clinical outcomes the respiratory mechanics group compared with control group.Days of mechanical ventilation (6.40±0.82) d vs (5.20± 0.63) d (P＜0.05) and RICU length of stay (10.49±1.32) d vs (8.83±t0.88) d (P ＜0.05) were shortened.The incidence of barotrauma declined (11.32％ vs 3.33％,P ＜ 0.01).Conclusions Monitoring of respiratory mechanics in patients with invasive mechanical ventilation can induce days of mechanical ventilation and RICU length of stay,improve the safety of mechanical ventilation.