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本文测定了7例慢性阻塞性肺病(COPD)呼衰患者机械通气时内源性呼气末正压(PEEPi),并观察了吸气流速(V_T/Ti)分别为0.45、0.55、0.65L/s,吸气时间(Ti)分别为0.8、1.0、1.2s,呼吸频率(RR)分别为15、20、25次/min和呼气末正压(PEEP)分别为0、0.29、0.49kPa时PEEPi的变化以及喘乐宁对PEEPi的疗效。随着V_T/Ti、Ti、RR的增加,PEEPi均可明显升高,但提高单位V_E时,延长Ti所致的PEEPi增加幅度最大。胸肺顺应性经PEEPi校正后可明显增高。PEEP的提高可使PEEPi相应降低。应用800μg喘乐宁气雾剂喷雾和100mg喘乐宁溶液雾化治疗,用药后10、30和60min时PEEPi均明显下降,分别由用药前的0.65±0.29kPa和0.81±0.41kPa下降至用药后60min的0.47±0.22kPa和0.58±0.32kPa。
In this paper, endogenous positive end expiratory pressure (PEEPi) was measured in 7 patients with chronic obstructive pulmonary disease (COPD) respiratory failure under mechanical ventilation and the inspiratory flow rate (V_T / Ti) was measured as 0.45,0.55,0.65 L / s, the inspiratory time (Ti) were 0.8,1.0,1.2s, respiratory rate (RR) were 15,20,25 times / min and positive end expiratory pressure (PEEP) were 0,0.29,0.49 kPa Changes in PEEPi and the efficacy of salbutamol on PEEPi. With the increase of V_T / Ti, Ti and RR, PEEPi could be obviously increased, but when the unit of V_E was increased, the increase of PEEPi caused by extending Ti was the largest. Thoracic compliance was significantly higher after PEEPi correction. The increase of PEEP can reduce PEEPi accordingly. Application of aerosol spray aerosol 800μg and 100mg salbutamol solution atomization treatment, PEEPi 10, 30 and 60min after treatment were significantly decreased, respectively, by the 0.65 ± 0.29kPa before medication and 0.81 ± 0.41kPa decreased to after treatment 0.47 ± 0.22 kPa and 0.58 ± 0.32 kPa for 60 min.