心脑血管疾病患者心肺复苏期间不同呼吸机参数设置对经皮氧饱和度影响.docVIP

心脑血管疾病患者心肺复苏期间不同呼吸机参数设置对经皮氧饱和度影响 　　[摘要] 目的 探讨心肺复苏期间不同气道高压报警上限及触发水平设置对心脑血管疾病患者复苏时经皮氧饱和度的影响。 方法 选择2013年3月～2015年12月在丽水市中心医院急诊医学科行心肺复苏的患者60例，分为观察组和对照组。对照组设置气道高压上限为40 cmH2O水平，触发灵敏度为-2～-1 cmH2O。观察组则在对照组的基础上提高气道高压报警上限到60 cmH2O，触发灵敏度调到最大绝对值（20 cmH2O）。观察监测胸外按压进入平稳状态后，在连续2 min内每10秒的SPO2平均值，以及SPO2在60%～79%、80%～89%的发生例数，记录报警事件发生次数等。 结果 观察组在SPO2在60%～79%、80%～89%的两个情况下SPO290%的发生率显著低于对照组，在SPO2≥90%的比率上观察组显著高于对照组，差异有统计学意义（P0.05）。在复苏期间的SPO2变化中观察组显著高于对照组，且观察组的报警事件次数显著低于对照组，差异有统计学意义（P0.05）。 结论 在心肺复苏中VCV模式采用减速波，通过上调呼吸机压力报警上限到60 cmH2O，调高压力触发灵敏度水平到最大绝对值（20 cmH2O），可以明显较少不必要的报警和通气频率发生，促进人机协调，提高患者心肺复苏期间的氧合水平，减少低氧血症的发生。 　　[关键词] 心脑血管疾病；心肺复苏；机械通气；气道压力；触发水平；经皮氧饱和度 　　[中图分类号] R459.7 [文献标识码] B [文章编号] 1673-9701（2016）16-0147-03 　　[Abstract] Objective To investigate the effect of high pressure alarm limits and trigger level set of different airway on the transcutaneous oxygen saturation during cardio-pulmonary resuscitation of patients with cardiovascular and cerebrovascular diseases. Methods 60 patients who were performed CPR in the department of emergent medicine in Lishui Central Hospital from March 2013 to December 2015 were selected and divided into observation group and control group. The high pressure limit was set at 40 cmH2O level of the control group and the trigger sensitivity was -2～-1 cmH2O. The high pressure alarm limit of the observation group was increased to 60 cmH2O on the basis of control group and the trigger sensitivity was set to the maximize value of 20 cmH2O. The SPO2 mean value/10 seconds in a successive 2 minutes were observed and monitored after external chest compression was stable as well as the incidence cases of SP02 at 60%-79% and 80%-89% and the alarm events were recorded. Results The incidence rate of SPO2 　　[Key words] Cardiovascular and cerebrovascular disease； Cardio-pulmonary resuscitation； Mechanical ventilation； Airway pressure； Trigger level； Transcutaneous oxygen saturation 　　随着急诊医学新技术的不断发展，传统的 CPR处理方法不断更新，对心肺复苏的不断探索，将对心肺复苏的革新产生重大影响[1]。在急诊医学科进行心肺复苏的心脑血管疾病