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目的：探讨从呼吸功角度评价呼吸机脱机方式优劣的可能性及其意义。方法：通过ＢｉｃｏｒｅＣＰ１００呼吸监测仪测定２２例患者在压力支持通气（ＰＳＶ）、持续气道内正压（ＣＰＡＰ）通气、Ｔ管及拔管后２小时等条件下的呼吸功的变化。结果：ＣＰＡＰ０．４９ｋＰａ（１ｋＰａ＝１０．２０ｃｍＨ２Ｏ）、Ｔ管、ＰＳＶ０．４９ｋＰａ时，患者呼吸功依次逐渐降低。ＣＰＡＰ０．４９ｋＰａ时呼吸功（９．９８Ｊ／ｍｉｎ）比ＰＳＶ０．４９ｋＰａ时高２３．７％（Ｐ＜０．００１），比拔管后２小时高４８．５％（Ｐ＜０．０１），与Ｔ管时比较无显著性差异。Ｔ管时呼吸功（９．３１Ｊ／ｍｉｎ）比ＰＳＶ０．４９ｋＰａ时高１５．４％（Ｐ＜０．０５），比拔管后２小时高３８．５％（Ｐ＜０．０１）。结论：患者呼吸功因脱机方式不同而显著不同，ＰＳＶ０．４９ｋＰａ比ＣＰＡＰ０．４９ｋＰａ和Ｔ管更有利于脱机。
Objective: To explore the possibility and significance of evaluating the advantages and disadvantages of ventilator off-line mode from the perspective of respiratory work. Methods: The changes of respiratory work in 22 patients under pressure support ventilation (PSV), continuous positive airway pressure (CPAP) ventilation, T tube and 2 hours after extubation were measured by Bicore CP100 respiration monitor. Results: CPAP 0.49kPa (1kPa = 10.20cmH2O), T tube, PSV 0.49kPa, the patient’s respiratory work successively decreased. Respiratory work (9.98 J / min) at CPAP 0.49 kPa was 23.7% (P <0.001) higher than PSV 0.49 kPa, 48.5% higher than 2 hours after extubation (P <0.01) There was no significant difference with T tube. T-tube respiratory work (9.31 J / min) was 15.4% (P <0.05) higher than PSV 0.49 kPa and 38.5% higher than 2 hours after extubation (P <0.01). CONCLUSIONS: The patient’s work-related power varies significantly with offline mode, with PSV 0.49 kPa being more favorable for off-line than CPAP 0.49 kPa and T-tube.