【摘要】 目的研究机械通气时不同呼气末正压(PEEP)参数对慢性阻塞性肺疾病(COPD)患者肝脏形态、功能及血流动力学的影响。方法采用前瞻性、开放性、自身对照的研究方法,对50例因COPD呼吸衰竭行机械通气的患者,待其病情稳定后,观察在PEEP分别为0、5、10 cmH2O时腹腔压力(IAP)的改变,以及肝脏形态、肝门静脉内径、血流动力学和肝功能的变化。结果随着PEEP值增大,IAP随之增加(P<0.01);肝脏形态未发生明显变化,门静脉内径无显著改变(P>0.05),门静脉血流减慢(P<0.05),肝功能改变差异无统计学意义(P>0.05)。结论机械通气时较高的PEEP值会使IAP升高、门静脉血流减慢,但门静脉内径及肝功能所受影响不明显。更多还原

【Abstract】 Objective To research the impact of various PEEP parameters of mechanical ventilation on liver morphology and function and on hemodynamics. Methods Fifty patients of respiratory failure due to COPD using mechanical ventilation was observed by prospective, exoterical and self-control methods after their condition were stabilized. The variation of abdominal pressure was measured with different PEEP of 0 cmH2O, 5 cmH2O and 10 cmH2O with mechanical ventilation, and measured when patients breathe autonomously with tracheostomy tube. The changes of liver morphology, hepatic portal vein diameter, hemodynamics and liver function were also measured on above circumstances. Results With PEEP value increases: the abdominal pressure(IAP) rise(P < 0.01) while liver morphology, function and hepatic portal did not change markedly evidently(P > 0.05). By contrast, blood flow of hepatic portal vein reduced with PEEP increase(P < 0.05). Conclusion Higher PEEP values on mechanical ventilation will causes abdominal pressure increases and low blood flow of hepatic portal,butnotobviousimpact on portal vein diameter and liver function.更多还原