【摘要】：目的探討COPD患者機械通氣時選擇不同通氣模式下,人機同步性及舒適性的比較。為COPD病人探索更適宜的通氣方案。方法選擇80例行有創(chuàng)機械通氣的COPD患者,分為神經(jīng)調(diào)節(jié)輔助通氣(NAVA)組17例、適應性支持通氣組(ASV)33例、實施壓力控制通氣-壓力支持的常規(guī)對照組30例。在保持分鐘通氣量基本相似的情況下,對比所有組患者的呼吸力學指標、血氣指標和血流動力學指標,并采用量表分析患者上機時的呼吸機不合拍程度(人機對抗率)。結(jié)果各組患者的年齡、性別、APACHEⅡ評分結(jié)果無差異;NAVA組患者指令呼吸頻率較低,NAVA組和ASV組患者的潮氣量均比對照通氣組大,P值均0.05。量表評估NAVA、ASV、對照組的人機對抗率分別為29.4%(5/17)、21.2%(7/33)、40%(12/30),差異顯著(P0.01)。結(jié)論 NAVA和ASV通氣均可保持較好的自主呼吸,降低人機對抗率,是符合COPD患者需要的通氣模式。
[Abstract]:Objective to explore the comparison of man-machine synchrony and comfort under different ventilation modes in patients with COPD. To explore a more suitable ventilation scheme for COPD patients. Methods 80 COPD patients with invasive mechanical ventilation were divided into (NAVA) group (n = 17), (ASV) group (n = 33) and control group (n = 30). The respiratory mechanics indexes, blood gas indexes and hemodynamic indexes of all patients were compared with each other while the minute ventilation volume was basically similar, and the degree of mechanical ventilation (man-machine antagonism) was analyzed by using the scale when the patients were on the machine. Results there was no difference in age, sex and Apache 鈪，

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