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目的 评价呼吸机、气管导管等器械阻力导致的附加功 (WOBimp)对患者呼吸功 (WOBp)的影响。方法 通过Ventrak 15 5 0呼吸监测仪 ,测定 18例患者不同机械通气条件下WOBp和WOBimp的变化。结果 持续气道正压 (CPAP) 5cmH2 O时 ,WOBp为 (10 14± 3 46 )J/min ,分别比压力支持通气 (PSV) 5cmH2 O和T管高 48 5 % (P <0 0 5 )和 2 3 7% (P >0 0 5 ) ,但比CPAP 0cmH2 O低 7 2 % (P >0 0 5 )。CPAP 5、 0cmH2 O和T管时 ,WOBimp占WOBp的比例分别为 5 8%、 5 1%和 42 %。CPAP 5cmH2 O时 ,WOBimp为 (0 78± 0 2 4)J/L ,分别比PSV 5cmH2 O〔(0 34± 0 13)J/L〕和T管〔(0 5 3± 0 14)J/L〕高 48 5 % (P <0 0 5 )和 2 3 7%(P <0 0 5 )。结论 呼吸机及气管导管导致的WOBimp使WOBp明显增加 ,气管导管是WOBimp明显增加的主要因素
Objective To evaluate the effect of additional work (WOBimp) on the patient’s work of breathing (WOBp) by ventilator, endotracheal tube and other devices. Methods The changes of WOBp and WOBimp in 18 patients under different mechanical ventilation were measured by Ventrak 15 50 breath monitor. Results WOBp was (10 14 ± 3 46) J / min at 5 cm H 2 O with continuous positive airway pressure (CPAP) and 48 5% higher than PSV 5 cm H 2 O and T tube (P 0 05) And 23.7% (P> 0.05) respectively, but it was 72% lower than 0cmH2O of CPAP (P> 0.05). CPAP 5, 0cmH 2 O and T tube, WOBimp accounted for 58% WOBp, 51% and 42% respectively. (0 78 ± 0 2 4) J / L for WOBimp and 5 cmH 2 O [(0 34 ± 0 13) J / L] for PSAP and 5 L] were 48.5% (P <0.05) and 23.7% (P <0 05) respectively. Conclusion WOBimp caused by ventilator and endotracheal tube significantly increased WOBp, and tracheal tube was the main factor for the significant increase of WOBimp