摘要
近20年来，医疗水平进展迅猛，但是包括ARDS在内的复杂疾病或综合征仍然有很高的病死率，主要是缺乏针对性治疗措施。ARDS的特点表现为功能残气量的下降和呼吸系统静态顺应性的增加，其中胸壁顺应性可能在ARDS患者呼吸机相关性肺损伤的发病机制方面起到重要作用。在治疗ALI和ARDS患者时，需要对肺顺应性和胸壁顺应性有充分的认识。测量食道压可以作为评估胸腔压的最佳手段，也可以对呼吸力学的研究提供可靠数据。为ARDS患者设定适宜呼气末正压的目的是保持肺泡持续膨胀，尽量避免肺泡进入膨胀一陷闭的循环中。在床旁应用食道气囊法来测量食道压并由此计算胸腔压和跨肺压是可行的，目前这种方法是研究ARDS病理学特点的最佳手段，同时也有助于选择最适宜的机械通气策略。
In the past 20 years, the medical level progresses rapidly, but the mortality rate of complex diseases,including acute respiratory distress syndrome （ARDS）,or other diseases are still high, mainly due to the shortage of corresponding treatment measures. The characteristics of ARDS are the reduction of functional residual capacity and the increase of chest wall compliance, the latter one maybe plays a significant role in ventilator associated lung injury in ARDS patients. For ARDS patients, setting appropriate PEEP is to keeping the continuous expansion of the alveoli, avoiding alveolar into inflation-in closed loop. In the treatment of patients with acute lung injury or ARDS, it is necessary to deeply understand the lung compliance and chest wall compliance. Esophageal pressure measurement could be a better method to evaluate the chest pressure, which will provide reliable data for respiratory mechanics research. On the other hand, this method is the best one to help choosing the most suitable mechanical ventilation strategy so far.
出处
《国际呼吸杂志》
2014年第A01期44-49,共6页
International Journal of Respiration
关键词
跨肺压
急性呼吸窘迫综合征
胸壁顺应性
食道气囊法
Transpulmonary pressure
Acute respiratory distress syndrome
Chest wall compliance
Esophageal balloon method
