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近年来对高频喷射通气(High-frequency jet ventilation. HFJV)已引起极大重视。该法的最大优点是用最小的气道压能维持充分的通气。本例报告气管软化所致急性呼吸衰竭在应用传统的机械通气无效时,改用HFJV取得满意的效果。患者女、77岁,在基层医院剖腹探查确诊为急性胰腺炎,术后发生肾功能衰竭和急性呼吸衰竭。术后18天转至本院加强监护病房(ICU)行血液透析和连续通气治疗。插入低容量高压双套囊气管导管,反复吸出肺渗出物。由于严重的气管软化,套囊充气后仍大量漏气,以致肺膨胀不全,肺泡通气不良。经过处理肾功能得到改善,并以静脉维持高营养,但用各型气管导管均不能解决漏气问题。而改用同步间断指令通气(SIMV):潮气量1升,SIMV14次/分,FIO_20.4、血气分析仍不理想(PaCO_254托,PaO_276托,pH7.30),
In recent years, high-frequency jet ventilation (HFJV) has drawn great attention. The biggest advantage of this method is to maintain adequate ventilation with minimal airway pressure. This case report of acute respiratory failure caused by tracheal softening in the use of traditional mechanical ventilation is invalid, switch to HFJV to obtain satisfactory results. Female, 77 years old, diagnosed as acute pancreatitis by laparotomy in primary hospital, with renal failure and acute respiratory failure after surgery. 18 days after surgery to our hospital intensive care unit (ICU) hemodialysis and continuous ventilation treatment. Insert a low-volume, high-pressure, double-cuffed endotracheal tube and repeatedly aspirate the lung exudate. Due to severe tracheal softening, cuff inflation is still a large number of leaks, resulting in incomplete lung expansion, poor alveolar ventilation. After treatment, renal function is improved and high nutrition is maintained by vein. However, various tracheal tubes can not solve the problem of air leak. (SIMOV): 1 liter of tidal volume, SIMV 14 beats / min, FIO_20.4, blood gas analysis is still not ideal (PaCO_254 care, PaO_276 care, pH7.30)