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目的 探讨吸入氦 氧混合气对重症慢性阻塞性肺病 (COPD)机械通气患者的治疗作用以及对机械通气患者脱机的作用。方法 选择 12例重症COPD机械通气患者随机分为氦 氧混合气组 (70 %氦 ;30 %氧 )和对照组 (FiO2 :30 % ) ,观察治疗前、治疗后 30、 90min、 6h的呼吸力学指标 (气道峰压、平台压、吸气阻力、呼气阻力 )以及内源性呼气末正压的变化 ;选择准备脱机的机械通气患者 6例 ,按自身对照方式脱机后随机先后吸入氦 氧混合气 (70 %氦 30 %氧 )或低浓度氧 (FiO2 :30 % )观察治疗前、治疗后 30、 90min、 6h和停止治疗后 30min (重新上机进行压力支持通气 )的动脉血气指标。结果 机械通气患者应用氦氧混合气治疗后气道压力、气道阻力和内源性呼气末正压均有明显下降 ,与对照组比较差异有显著性意义 ;脱机患者吸入氦 氧混合气后与对照组比较pH、PaO2 、PaCO2 差异均具有显著性意义。结论 吸入氦 氧混合气在治疗重症COPD机械通气患者方面能够明显降低气道压力和气道阻力 ,避免气压伤的发生 ;应用氦氧混合气可以有效避免脱机患者血气指标的恶化 ,可能有助于患者的顺利脱机
Objective To investigate the therapeutic effect of inhaled helioxan on patients with severe chronic obstructive pulmonary disease (COPD) with mechanical ventilation and the effect of taking helium-oxygen mixture on patients taking off mechanically ventilated patients. Methods Twelve patients with severe COPD were randomly divided into three groups: the Helioxeacetam group (70% helium; 30% oxygen) and the control group (FiO2: 30%), and the respiratory mechanics were observed before and 30, 90, Index (peak airway pressure, plateau pressure, inspiratory resistance, expiratory resistance) and endogenous positive changes in end-expiratory pressure. Six patients with mechanical ventilation who were prepared to go offline were randomized according to their own control methods The arteries of pre-treatment, post-treatment 30, 90min, 6h, and 30min after treatment discontinuation (re-access to pressure support ventilation) were observed by inhalation of helium-oxygen mixture (70% helium 30% oxygen) or low concentration oxygen (FiO2: 30% Blood gas index. Results Compared with the control group, airway pressure, airway resistance and endogenous positive end-expiratory pressure were significantly decreased in patients with mechanical ventilation after heliox treatment. There was no significant difference between the two groups Compared with the control group, the differences of pH, PaO2 and PaCO2 were all significant. Conclusions Helic-oxygen inhalation can significantly reduce airway pressure and airway resistance and prevent barotrauma in the treatment of severe COPD patients. Helic-oxygen mixture can effectively avoid the worsening of blood gas indexes in off-line patients, which may be helpful to The patient went offline smoothly