目的比较压力调节容量控制通气(PRVC)模式和容控同步间歇指令通气(容控SIMV)模式对急性呼吸窘迫综合征(ARDS)患者的治疗效果及安全性。方法从2009年9月—2013年1月在蚌埠市第三人民医院ICU的住院患者中选取31例诊断为ARDS患者作为研究对象,将这些患者随机分为容控SIMV组和PRVC组,2组年龄、性别、机械通气前的血压及动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)差异无统计学意义(P<0.05)。测定患者通气6 h后的气道峰压、平台压,并对患者行血气分析检查测定PaO2、PaCO2和SaO2,并测量2组患者的血压,比较上述指标之间的差异。结果 PRVC组患者的气道峰压、平台压均低于容控SIMV组(P<0.05),差异有统计学意义,PRVC组的PaO2、SaO2均高于容控SIMV组(P<0.05),差异有统计学意义,2组的PaCO2、收缩压、舒张压差异无统计学意义(P>0.05)。结论对于急性呼吸窘迫综合征患者的治疗来说,使用PRVC模式机械通气时气道峰压和平台压可能较使用容控SIMV模式低,且改善氧合的作用可能优于容控SIMV模式,对血压的影响两者无明显差异,故PRVC模式或许是较容控SIMV模式更为安全有效的一种通气模式。 Objective To compare the efficacy and safety of pressure-controlled volume controlled ventilation (PRVC) and accommodative synchronized intermittent mandatory ventilation (volume-controlled SIMV) in patients with acute respiratory distress syndrome (ARDS). Methods From September 2009 to January 2013, 31 patients diagnosed as ARDS were enrolled in the inpatient population of ICU of the Third People’s Hospital of Bengbu City. These patients were randomly divided into SIMV group and PRVC group, and two groups There were no significant differences in age, sex, pre-mechanical blood pressure and PaO2, PaCO2, SaO2 between the two groups (P <0.05). The airway peak pressure and plateau pressure were measured 6 h after ventilation, and PaO2, PaCO2 and SaO2 were measured and the blood pressure was measured. The blood pressure was measured between the two groups, and the differences between the above indexes were compared. Results Compared with SIMV group (P <0.05), the peak airway pressure and plateau pressure in PRVC group were significantly lower than those in control SIMV group (P <0.05) There was significant difference between the two groups, PaCO2, systolic blood pressure and diastolic blood pressure difference was not statistically significant (P> 0.05). Conclusions For the treatment of patients with acute respiratory distress syndrome, airway peak pressure and plateau pressure may be lower in the PRVC-mode mechanical ventilation than in the accommodative SIMV mode, and oxygenation may be better than the SIMV-tolerant There is no significant difference between the two effects of BP, so the PRVC mode may be a safer and more effective ventilation mode than SIMV mode.