适应性支持通气在食管癌术后患者中的临床应用研究

目的：通过与临床常用的同步间歇指令通气（SIMV）模式比较,探讨适应性支持通气（ASV）模式在食管癌术后患者中的应用价值.方法：选取全麻下行食管癌根治术后患者153例,分为ASV组,SIMV组.ASV组选用ASV通气模式,SIMV组选用SIMV通气模式,观察对比两组患者呼吸频率、潮气量、吸气峰压、血流动力学指标、动脉血气分析指标、呼吸机耐受状况、呼吸功、脱机成功率、机械通气时间.结果：两组患者在进行机械通气时,动脉血气分析、血流动力学指标、呼吸频率、潮气量、脱机成功率方面无统计学差异（P＞0.05）;ASV组患者的机械通气时间、气道峰压、呼吸功明显低于SIMV组,差异具有统计学意义（P＜0.05）.结论：在食管癌术后患者中ASV模式能够获得与SIMV模式相同的通气、撤机目标,并且在降低气道峰压、呼吸功,改善人机对抗,缩短机械通气时间方面较SIMV模式具有一定优势.

Clinical study on adaptive support ventilation in postoperative patients with esophageal cancer

Objective： To compare the effects of adaptive support ventilation （ASV） in postoperative patients with esophageal cancer with that of conventional venting mode, synchronized intermittent mandatory ventilation （SIMV）. Methods： One hundred and fifty-three postoperative patients with esophageal cancer were assigned to an ASV group and a SIMV group as control. The RR, TV, Ppeak, arterial blood gas, the tolerance of breathing machine, hemodynamic parameters, duration of mechanical ventilation, and work of breathing and results of weaning were recorded. Results： During mechanical ventilation, the arterial blood gas, hemodynamic parameters, RR,TV, and results of weaning were of no significant differences between the two groups （P〉0.05）. Compared with the SIMV group, the duration of mechanical ventilation, Ppeak and work of breathing were significantly lower in ASV group （P〈0.05）. Conclusion： In the postoperative patients with esophageal cancer, the ASV can achieve similar results with SIMV, and is more effective in lowering Ppeak, reducing work of breathing, increasing the patients＇ tolerance to breathing machine and shortening the average duration of mechanical ventilation.