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目的 探讨BiPAP -S/T -D30通气支持系统的临床应用方法及其效果。方法 对通气效果及其对呼吸功能的影响、该系统配件方便呼气孔与碟式呼气活瓣在不同支持压力水平对CO2 排出量的影响、通气支持与使用呼吸兴奋剂的关系进行了观察。结果 通气后PaCO2 下降 1 0 8kPa(P <0 0 1) ,PaO2 升高 2 2 1kPa(P <0 0 0 1) ;呼吸频率下降 (P <0 0 1) ,潮气量、吸气峰值流速和指端血氧饱合度明显增加 (P <0 0 5 ) ,平均吸气流速即潮气量与吸气时间比略下降但无明显统计学差异(P >0 0 5 )。方便式呼气孔与碟式呼气活瓣在低于 10cmH2 O和大于 2 0cmH2 O支持压力时二者对动脉血二氧化碳影响无明显统计学差异 (P >0 0 5 ) ,而 10～ 15cmH2 O压力支持时使用碟式呼气活瓣的效果明显优于方便式呼气孔 (P <0 0 0 1) ;并用呼吸兴奋剂能改善病人的意识状态 ,提高使用BiPAP呼吸的顺从性。结论 合理选用碟式呼气活瓣 ,适当加用呼吸兴奋剂可提高通气改善的效果和使用呼吸机的顺从性。
Objective To investigate the clinical application of BiPAP-S / T-D30 ventilation support system and its effect. Methods The ventilatory effects and their effects on respiratory function were studied. The effects of the system accessories on the CO2 emission at different supportive pressure levels and the relationship between ventilation support and the use of respiratory stimulants were investigated. . Results PaCO2 decreased by 108 kPa (P <0.01), PaO2 increased by 221 kPa (P <0.01), respiratory rate decreased (P <0.01), tidal volume, peak inspiratory flow rate and Finger oxygen saturation increased significantly (P <0 05). The mean inspiratory flow rate, tidal volume and inspiratory time slightly decreased but no significant difference (P> 0.05). There was no significant difference (P> 0.05) between the two types of breath expiratory valve and the disc-type expiratory valve in arterial blood carbon dioxide when the supporting pressure was less than 10cmH2O and more than 20cmH2O. The use of the disc-type expiratory valve in pressure support was significantly better than that in the convenience-type expiratory volume (P <0.01), and the use of respiratory stimulants improved the patient’s state of consciousness and improved the compliance with BiPAP respiration. Conclusion The rational use of disc breath valve, appropriate use of respiratory stimulants can improve the effectiveness of ventilation and the use of breathing machine compliance.