摘要： 观察并比较压力释放通气（APRV）和压力控制通气（PCV ）模式对重型颅脑创伤并发低氧血症患者脑血氧代谢的改善效果。经颅内压、脑血流、氧分压等指标监测显示，11例患者经APRV 模式辅助呼吸30min 后低氧血症即得到明显改善，而颅内压平均值与PCV 模式十分相近（P > 0.05 ）；在APRV模式下颈内动脉血流量和动脉血氧分压提高，分别为（528.82 ± 65.27）ml/min 和（132.49 ± 20.30）mm Hg，PCV 模式为（430.27 ± 33.44）ml/min 和（79.38 ± 10.22）mm Hg，两种通气模式对脑氧代谢改善效果 差异有统计学意义（均 P < 0.05 ）。提示 APRV 模式可在不增加颅内压的情况下，更好地改善氧供和低氧血症。
关键词:
,
连续气道正压通气,
颅脑损伤,
缺氧,
颅内压
Abstract: The article aims to observe and compare the efficiency of airway pressure release ventilation (APRV) and pressure controlled ventilation (PCV) on patients with severe traumatic brain injury (sTBI) complicated with hypoxemia. The monitoring of intracranial pressure (ICP), cerebral blood flow (CBF) and arterial partial pressure of oxygen (PaO 2 ) showed 11 patients with hypoxemia had been significantly improved by 30 minutes of APRV. The ICP in APRV was similar with that in PCV ( P > 0.05). CBF and PaO2 under APRV mode were (528.82 ± 65.27) ml/min and (132.49 ± 20.30) mm Hgresp ectively, and (430.27 ± 33.44) ml/min and (79.38 ± 10.22) mm Hgresp ec tively under PCV mode. The differences were statistically significant (P < 0.05, for all). Therefore, APRV could be effective in improving oxygen supply and hypoxemia without increasing ICP.
Key words:
Continuous positive airway pressure,
Craniocerebral trauma,
Anoxia,
Intracranial pressure
翟国岩, 张彬. 压力释放通气模式对重型颅脑创伤患者颅内压和低氧血症影响的临床观察[J]. 中国现代神经疾病杂志, 2013, 13(4): 338-341.
ZHAI Guo-yan, ZHANG Bin. Clinical observations on the effect of airway pressure release ventilation on intracranial pressure and hypoxemia of patients with severe traumatic brain injury[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2013, 13(4): 338-341.