摘要
目的利用准静态法描记急性呼吸窘迫综合征（ARDS）患者压力-容积曲线（P—V曲线），分析其呼气支的回归点与呼气末死腔变化的关系。方法采用前瞻性研究方法，选取本院14例接受机械通气的ARDS患者，用准静态法描记P—V曲线，描记时将潮气量表连接于流量传感器，记录呼气支呼气起始时的潮气量（VT1）和呼气结束时的潮气量（VT2），计算其差值（AV，=VT1-VT2）；同时记录呼气过程中流量传感器显示的潮气量（VT3）和预设潮气量（VT4）；并对△VT与VT3以及VT4与VT1进行相关性分析。结果△VT为（417．40±119．68）ml，VT3为（399．29±121．36）ml；△VT与VT3具有很好的相关性（r=0．99，P=0．000），说明呼气支△VT与肺内陷闭气体量相关。VT4为（908．21±106．52）ml，VT1为（892．26±106．32）ml；VT4与VT1具有很好的相关性（r=0．99，P=0．000）。结论ARDS患者可能因呼气末部分气体陷闭，导致死腔增加，显示P—V曲线呼气支无法回到基点，且呼气支△VT与陷闭气体量成反比。
Objective To trace pressure-volume curves （P-V curves） with quasi-static technique in acute respiratory distress syndrome （ARDS） patients, and using it to explain the relationship between the end point of the expiratory limb and the change in the dead space of expiration. Methods A prospective study was conducted. Fourteen ARDS patients receiving mechanical ventilation were included in the study. When P-V curves was traced with quasi-static technique, the spirometer was connected to the flow sensor. The start point of the expiratory limb was defined as tidal volume 1 （VT1） and the end point as VT2, and the difference between them （ △ VT：VTI --VT2） was calculated. The VT of spirometer （named VT3 ） and the predetermined VT （VT4） were recorded. Correlations of A VT and VT3, as well as VT4 and VT1, were analyzed with correlation analysis. Results △ VT was （417.40 ± 119.68） ml, and VT3 was （399.29 ± 121.36） ml, AVT and VT3 showed a good correlation （r=0.99, P=0.000）, demonstrating that the △ VT of the expiratory limb was correlated with the volume trapped in lung. VT4 was （908.21 ± 106.52 ） ml, and VT1 was （892.26 ± 106.32） ml, and they showed a good correlation （r=0.99, P=0.000）. Conclusion Because of part of the gas trapped at the end of expiration in ARDS patients, the dead space is increased, showing that the expiratory limb of the P-V curve cannot return to the base points, and the △ VT of the expiratory limb is inversely proportional to the gas volume trapped in lung.
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2013年第3期132-135,共4页
Chinese Critical Care Medicine
基金
基金项目：国家重点基础研究发展计划（973）项目资助（2009CB522702）
关键词
压力-容积曲线
呼气支
急性呼吸窘迫综合征
死腔
Pressure-volume curve
Expiratory limb
Acute respiratory distress syndrome
Dead space
