PRVC和容控SIMV对ARDS患者的疗效及安全性比较

目的比较压力调节容量控制通气（PRVC）模式和容控同步间歇指令通气（容控SIMV）模式对急性呼吸窘迫综合征（ARDS）患者的治疗效果及安全性。方法从2009年9月—2013年1月在蚌埠市第三人民医院ICU的住院患者中选取31例诊断为ARDS患者作为研究对象,将这些患者随机分为容控SIMV组和PRVC组,2组年龄、性别、机械通气前的血压及动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、动脉血氧饱和度（SaO2）差异无统计学意义（P〈0.05）。测定患者通气6 h后的气道峰压、平台压,并对患者行血气分析检查测定PaO2、PaCO2和SaO2,并测量2组患者的血压,比较上述指标之间的差异。结果 PRVC组患者的气道峰压、平台压均低于容控SIMV组（P〈0.05）,差异有统计学意义,PRVC组的PaO2、SaO2均高于容控SIMV组（P〈0.05）,差异有统计学意义,2组的PaCO2、收缩压、舒张压差异无统计学意义（P〉0.05）。结论对于急性呼吸窘迫综合征患者的治疗来说,使用PRVC模式机械通气时气道峰压和平台压可能较使用容控SIMV模式低,且改善氧合的作用可能优于容控SIMV模式,对血压的影响两者无明显差异,故PRVC模式或许是较容控SIMV模式更为安全有效的一种通气模式。

The comparison of efficacy and safety to acute respiratory distress syndrome between pressure-regulated volume control ventilation and volume controlled synchronized intermittent mandatory ventilation

Objective To compare the efficacy and safety to acute respiratory distress syndrome between pressure regulated volume control ventilation（ PRVC） and volume controlled synchronized intermittent mandatory ventilation（ SIMV）.Methods 31 patients with ARDS were included in the study. According to ventilation mode,they were divided into volume controlled SIMV group and PRVC group. After ventilation of 6 hours,peak airway pressure,plateau pressure,PaO2,PaCO2,SaO2,systolic blood pressure and diastolic blood pressure were measured. These indexes were compared.Results Peak airway pressure and plateau pressure in PRVC group were lower than those in volume controlled SIMV group（P〈0. 05）,PaO2 and SaO2in PRVC group were higher than those in volume controlled SIMV group（P〈0. 05）.There were no difference of PaCO2,systolic blood pressure and diastolic blood pressure between two groups（P 〉0.05）.Conclusion To the therapy of ARDS patients,PRVC mode perhaps was a safer and more effective ventilation mode.