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目的 探讨双相气道正压 (BIPAP)通气模式治疗急性呼吸窘迫综合征 (ARDS)的疗效。 方法 将 2 0例ARDS患者随机分为BIPAP组和间歇性正压通气 (IPPV)组行机械通气治疗 ,每组 10例。观察机械通气期间患者镇静剂和肌肉松弛剂用量 ,气道力学参数中吸气峰压 (PIP)、平台压 (Pplate)和呼气末正压 (PEEP)的变化以及机械通气的时间。 结果 15例 (75 % )治愈出院 ,5例死亡。BIPAP组机械通气时间 [(13± 7.5 )d]显著低于IPPV组 [(2 1± 11.6 )d](P <0 .0 5 )。BIPAP组安定、吗啡和万可松用量显著低于IPPV组 (P <0 .0 5 ) ;IPPV组PIP、Pplate和PEEP均显著高于BIPAP组 (P <0 .0 5 )。 结论 BIPAP通气模式人机关系协同性好 ,缩短了治疗ARDS的机械通气时间
Objective To investigate the efficacy of bipolar positive airway pressure (BIPAP) ventilation in the treatment of acute respiratory distress syndrome (ARDS). Methods Twenty patients with ARDS were randomly divided into BIPAP group and intermittent positive pressure ventilation (IPPV) group, with 10 patients in each group. The amount of sedatives and muscle relaxants, the PIP, Pplate and PEEP during mechanical ventilation and the time of mechanical ventilation were observed. Results 15 cases (75%) were cured and 5 patients died. The duration of mechanical ventilation in BIPAP group [(13 ± 7.5) d] was significantly lower than that in IPPV group [(21 ± 11.6) d] (P <0.05). The dosage of diazepam, morphine and venlafaxine in BIPAP group was significantly lower than that in IPPV group (P <0.05). The PIP, Pplate and PEEP in IPPV group were significantly higher than those in BIPAP group (P <0.05). Conclusion The BIPAP ventilation model has good synergistic effect of human-computer and shortens the time of mechanical ventilation for the treatment of ARDS