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目的:探讨压力控制通气(PCV)联合针刺法对肺内源性急性呼吸窘迫综合征呼吸力学和氧合作用的影响。方法:对70例急性呼吸窘迫综合征(ARDS)患者进行机械通气(MV)治疗。A组先用PCV联合针刺法,分别保持潮气量(VT)和平均气道压(MPaw)不变,后改为VCV;B组先用VCV,后改为PCV联合针刺法,保持血氧饱和度平稳0.5h后监测指标。受试者在5h内依次完成上述实验。结果:PCV时峰压(PIP)、平台压(Pplat)明显低于VCV时的PIP、Pplat(P均<0.01),而MPaw明显高于VCV时的MPaw(P<0.01);在保持MPaw相同时,氧合作用差异无统计学意义(P>0.05),患者均无气压伤。结论:PCV联合针刺法可以有效地控制PIP、Pplat,并保证氧合,实现肺保护性通气。
Objective: To investigate the effects of pressure controlled ventilation (PCV) combined with acupuncture on respiratory mechanics and oxygenation in patients with pulmonary acute respiratory distress syndrome. Methods: 70 patients with acute respiratory distress syndrome (ARDS) were treated with mechanical ventilation (MV). In group A, PCV combined with acupuncture was used to keep the tidal volume (VT) and mean airway pressure (MPaw) unchanged respectively, and then changed to VCV. Group B was treated with VCV and PCV combined with acupuncture to maintain blood Oxygen saturation after 0.5h monitoring indicators. Subjects completed the above experiments in 5h. Results: The peak pressures (PIP) and Pplat at PCV were significantly lower than those at VCV (P <0.01, P <0.01), while MPaw was significantly higher than that at VCV (P <0.01) At the same time, there was no significant difference in oxygenation (P> 0.05). There was no barotrauma in all patients. Conclusion: PCV combined with acupuncture can effectively control PIP, Pplat, and ensure oxygenation, lung protective ventilation.