| 持续气管内吹气方法的建立及压力释放阀在其中的应用 |
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| 引用本文： | 詹庆元,王辰,商鸣宇. 持续气管内吹气方法的建立及压力释放阀在其中的应用[J]. 中华结核和呼吸杂志, 1999, 22(9): 528-532 |
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| 作者姓名： | 詹庆元 王辰 商鸣宇 |
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| 作者单位： | 首都医科大学附属北京红十字朝阳医院!100020 |
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| 基金项目： | 国家人事部留学归国人员重点资助项目，北京市科技新星计划 |
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| 摘 要： | 目的 建立持续气管内吹气（ Ｃ Ｔ Ｇ Ｉ） 的方法，并探讨压力释放阀（ Ｐ Ｒ Ｖ） 在控制 Ｃ Ｔ Ｇ Ｉ所致气道压力过高中的作用。方法 自行设计、制作 Ｃ Ｔ Ｇ Ｉ装置； Ｐ Ｒ Ｖ 放置在呼吸机吸气管路中，其压力释放水平与设置的压力控制水平相同。选择健康犬９ 只，在相同压力控制水平及不同的吸呼比（２∶１ 或１∶２） 行 Ｐ Ｃ Ｖ（ 压力控制通气） ， Ｐ Ｃ Ｖ＋ Ｃ Ｔ Ｇ Ｉ（ Ｔ Ｇ Ｉ组） 及 Ｐ Ｃ Ｖ＋ Ｃ Ｔ Ｇ Ｉ＋ Ｐ Ｒ Ｖ（ Ｐ Ｒ Ｖ 组） 通气。对气体交换、呼吸力学、血流动力学和氧动力学指标进行监测。结果 在同一吸呼比， Ｔ Ｇ Ｉ 组气道吸气峰压（ Ｐ Ｉ Ｐ） 显著超过 Ｐ Ｒ Ｖ 组和 Ｐ Ｃ Ｖ 组（ Ｐ＜ ００１） ， Ｐ Ｒ Ｖ 组与 Ｐ Ｃ Ｖ 组相比差异无显著性；在不同吸呼比， Ｔ Ｇ Ｉ（２∶１） 组 Ｐ Ｉ Ｐ显著高于 Ｔ Ｇ Ｉ（１∶２） 组（ Ｐ＜ ００１） ； Ｔ Ｇ Ｉ组及 Ｐ Ｒ Ｖ 组 Ｐａ Ｃ Ｏ２ 较 Ｐ Ｃ Ｖ 组明显下降， Ｔ Ｇ Ｉ组较 Ｐ Ｒ Ｖ 组下降更明显； Ｐａ Ｏ２ 、血流动力学和氧动力学指标在各组间差异无显著性。结论 本研究设计和制作的 Ｃ Ｔ Ｇ Ｉ能有效改善肺泡通气，对血流动力学和氧动力学无显著影响， Ｐ Ｒ Ｖ 为安全使用 Ｃ Ｔ
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| 关 键 词： | 机械通气 气管内吹气 压力释放阀 |
Continuous tracheal gas insufflation during pressure control ventilation with a pressure relief valve |
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| ZHAN Qingyuan,WANG Chen,SHANG Mingyu,et al Beijing Institute of Respiratory Medicine,Beijing Red Cross Chaoyang Hospital Affiliate of Capital University of Medical Sciences,Beijing. Continuous tracheal gas insufflation during pressure control ventilation with a pressure relief valve[J]. Chinese journal of tuberculosis and respiratory diseases, 1999, 22(9): 528-532 |
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| Authors: | ZHAN Qingyuan WANG Chen SHANG Mingyu et al Beijing Institute of Respiratory Medicine Beijing Red Cross Chaoyang Hospital Affiliate of Capital University of Medical Sciences Beijing |
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| Affiliation: | Beijing Institute of Respiratory Medicine, Beijing Red Cross Chaoyang Hospital, Capital University of Medical Sciences, Beijing 100020. |
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| Abstract: | OBJECTIVE: To establish the method of continuous tracheal gas insufflation (CTGI) and investigate the role of pressure relief valve (PRV) in limiting high peak airway pressure induced by CTGI. METHODS: CTGI device was made by authors. Nine healthy mongrel dogs were mechanically ventilated by using Evita 2 (Drager Inc.). PRV was inserted into the ventilatory circuit for selected experiment steps and adjusted a threshold pressure equal to the preset inspiratory pressure. PCV, PCV + CTGI (TGI group) and PCV + CTGI + PRV (PRV group) were conducted in different inspiration/expiration (I/E) ratio of 1:2 and 2:1. Gas exchange, lung mechanics and hemodynamics status were monitored at the constant set inspiratory pressure of PCV. RESULTS: At the same I/E ratio, peak airway pressure in TGI group was higher than that of PRV and PCV group (P < 0.01), whereas PRV group maintained the preset inspiratory pressure as PCV group. At the different I/E ratio, peak airway pressure in TGI (2:1) group was higher than that of TGI (1:2) group(P < 0.01). PaCO2 in TGI and PRV group decreased significantly than that of PCV, TGI group was more lower than PRV group, PaO2, hemodynamics and oxygenation remained unchanged in all groups. CONCLUSIONS: The CTGI device is effective in improving alveolar ventilation with no significant influence on hemodynamics and oxygenation; A pressure relief valve is necessary to ensure the safe use of CTGI. |
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| Keywords: | Mechanical ventilation Tracheal gas insufflation Pressure relief valve |
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