双相气道正压通气在心脏直视术后的应用

目的评价双相气道正压通气(B IPAP)模式在心瓣膜置换术后机械通气患者中的应用效果。方法80例心脏瓣膜置换术后患者随机分成2组,每组40例,分别应用B IPAP模式和同步间隙指令通气(SIMV)模式进行辅助呼吸,监测血流动力学和气道参数的变化,计算呼吸指数以及镇静剂的用量。结果B IPAP组氧合指数(440.7±55.1)明显高于SIMV组(357.5±64.3),P<0.05;B IPAP组机械通气时间为(13.1±11.1)h,SIMV组(13.0±11.0)h,差异无统计学意义;两组在镇静剂的使用率方面亦差异无统计学意义,但在用量方面B IPAP组度非合剂(哌替啶+异丙嗪)平均用量小于SIMV组(P<0.05);两组脱机过程均顺利。结论B IPAP是心脏术后患者机械通气的一种较理想模式。

Biphasic intermittent positive airway pressure ventilation in patients after cardiac surgery

Objective To evaluate the effects of Biphasic intermittent positive airway pressure ventilation(BIPAP) in patients after cardiac valves replacement surgery.Methods Eighty patients underwent cardiac valves replacements were randomly assigned into two groups:BIPAP group and SIMV(synchronized intermittent mandatory ventilation) group,to receive the two mechanical ventilation mode respectively.Hemodynamic measurements,airway parameters,respiratory index(RI),duration of intubation and consumption of analgesics and sedatives were compared.Results The value of RI in BIPAP group(440.7±55.1) was significantly higher than that of SIMV group(357.5±64.3).There were no significant difference in hemodynamic measurements,duration of intubation and the ratio of consumption of analgesics and sedatives,but the mean mixture dose of pethidine and promethazine in BIPAP group(0.666±0.326)u was less than that in SIMV group((0.812)±0.375u,P<0.05).The weaning process in both groups was successfully.Conclusion BIPAP might be a better mode for patients after cardiac surgery.