有创-无创序贯撤机过程中呼吸与循环功能变化的研究

目的：了解有创－无创机械通气序贯治疗过程中慢性阻塞性肺疾病（COPD）患者呼吸和循环功能的变化,以评价该方法实施中的生理学效应。方法：选择接受气管插管机械通气的COPD患者12例,待“肺部感染控制窗”出现后,拔除气管插管,改用经鼻面罩压力支持通气＋呼气末正压（PSV＋PEEP）。分别于“肺部感染控制窗”出现后有创机械通气条件下,拔管后无创机械通气3h及鼻导管吸氧1h的条件下测定患者的呼吸和循环功能的变化。结果：有创机械通气改为无创机械通气后,呼吸、循环各项指标变化均无统计学意义（P均＞0．05）。结论：有创－无创机械通气序贯撤机过程中,患者的呼吸和循环功能稳定,能够平衡地接受由有创性机械通气向无创性机械通气治疗的转换。

Changes in respiratory and circulatory function during sequential invasive-noninvasive mechanical ventilation

OBJECTIVE: To investigate the change of respiratory and circulatory function in COPD during sequential invasive-noninvasive mechanical ventilation. METHODS: 12 COPD patients with type II respiratory failure were ventilated via endotracheal intubation. When pulmonary infection was under control (the appearance of "PIC Window"), all patients were extubated and received mask ventilation. The parameters of hemodynamics oxygenation and esophageal pressure were measured during endotracheal ventilation and mask ventilation (3 hrs after extubation). RESULTS: The change of respiratory and circulatory parameters were not significantly different between invasive mechanical ventilation and noninvasive mechanical ventilation (P > 0.05). CONCLUSION: The respiratory and circulatory function of COPD patients remained stable during sequential invasive-noninvasive mechanical ventilation.