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  • 潘慧,徐亚伟,张翔宇,等.正压机械通气时腹内压与胸内压的相关性[J].同济大学学报(医学版),2011,32(6):53-57.    [点击复制]
  • PAN Hui,XU Ya-wei,ZHANG Xiang-yu,et al.Correlation between intra-abdominal and intra-plural pressure in patients with positive pressure ventilation[J].同济大学学报(医学版),2011,32(6):53-57.   [点击复制]
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正压机械通气时腹内压与胸内压的相关性
潘慧,徐亚伟,张翔宇,彭沪,葛奎,王启星
0
(同济大学附属第十人民医院急诊危重病科,上海200072)
摘要:
目的 探讨正压机械通气时,患者在麻醉肌松状态下,不同PEEP时腹内压与胸内压的相关性。方法 20例手术后尚处于麻醉肌松状态下,并行机械通气的患者,均留置胸腔闭式引流管和导尿管,在PEEP分别为0 cmH2O,5 cmH2O,10 cmH2O和15 cmH2O时,进行间接腹内压和直接胸内压测定。结果 所有20例患者的初始腹内压为(8.15±3.46)mmHg,初始胸内压为(9.31±5.72) mmHg,增加PEEP后,腹内压,胸内压均升高。当PEEP分别为5 cmH2O,10 cmH2O和15 cmH2O时,腹内压分别增加至(8.31±3.66) mmHg,(9.92±3.75) mmHg和(12.46±5.55) mmHg,胸内压分别增加至(9.15±5.93) mmHg,(12.23±6.29) mmHg和(16.23±5.99) mmHg。不同PEEP时,腹内压各组间两两比较,差异有统计学意义(P<0.05)。20例患者的腹内压与胸内压之间的相关性进行分析,其Pearson相关系数R2=0.789,且P<0.01,两者存在较强的正相关性。结论 在机械通气的过程中,提高PEEP值,能增加患者的腹内压。故对机械通气的患者,有必要实行腹内压监测。不同PEEP时,腹内压与胸内压具有较强的正相关性。
关键词:  机械通气  呼气末正压  腹内压  胸内压
DOI:10.3969/j.issn1008-0392.2011.06.011
基金项目:上海市自然科学基金(10411964800);上海市卫生局科研课题(2009143)
Correlation between intra-abdominal and intra-plural pressure in patients with positive pressure ventilation
PAN Hui,XU Ya-wei,ZHANG Xiang-yu,PENG Hu,GE Kui,WANG Qi-xing
(Dept.of Emergency and Critical Care Medicine,Tenth People’ s Hospital, Tongji University School of Medicine,Shanghai 200072,China)
Abstract:
Objective To assess the correlation of intra-abdominal pressure(IAP) with intra-pleural pressure(IPP) in patients under anesthesia and muscle relaxant condition with different positive endexpiratory pressure(PEEP).Methods In 20 mechanically ventilated patients who were anesthetic and muscle relaxed with closed drainage and catheter.Abdominal pressure were measured with indirect method and intrapleural pressure were measured with direct method at a sequentially increasing PEEP (0,5,10 and 15 cmH20).Results The IAP was 8.15±3.46 mmHg at PEEP 0(zero endexpiratory pressure,ZEEP),8.31±3.66 mmHg at PEEP 5,9.92±3.75 mmHg at PEEP 10 and 12.46±5.55 mmHg at PEEP 15(P<0.05 vs ZEEP).The IPP was 9.31±5.72 mmHg at PEEP 0 (ZEEP),9.15±5.93 mmHg,at PEEP 5,12.23±6.29 mmHg at PEEP 10 and 16.23±5.99 mmHg at PEEP 15.The intra-abdominal pressure was closely correlated with intrapleural pressure at different PEEP with a Pearson correlation coefficient R2 = 0.789(p<0.01).Conclusion Intra-abdominal pressure has close correlation with intra-pleural pressure in patients under anesthesia and muscle relaxation condition with different PEEP.
Key words:  mechanical ventilation  PEEP  intra-abdominal pressure  intrapleural pressure

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