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目的:探讨重症神经系统疾病气管切开患者应用神经调节辅助通气(NAVA)模式的人机协调性。方法:采用前瞻性研究方法,选择2019年9月至2020年2月入住皖南医学院第一附属医院弋矶山医院神经外科重症监护病房(NSICU)的16例进行气管切开机械通气的患者,按照随机数字法进行先压力支持通气(PSV)模式后NAVA模式,或者先NAVA模式后PSV模式机械通气治疗,每种模式下均通气24 h。每隔8 h记录每分钟误触发、无效触发、双触发、触发延迟、吸呼切换提前、吸呼切换延迟的次数及人机异步时间(触发延迟时间、吸呼切换提前时间、吸呼切换延迟时间),共记录3 min。比较两种通气模式下每种异步类型的平均每分钟异步次数、每种异步类型的异步指数(AI)、总AI、异步时间、动脉血气及呼吸力学参数变异系数(CV%)。结果:在NAVA模式下,误触发次数/指数、无效触发次数/指数、触发延迟次数/指数、吸呼切换提前次数/指数、吸呼切换延迟次数/指数均显著低于PSV模式〔误触发次数(次/min):0.00(0.00,0.00)比0.00(0.00,0.58),误触发指数:0.00(0.00,0.00)比0.00(0.00,0.02),无效触发次数(次/min):0.00(0.00,0.33)比1.00(0.33,2.17),无效触发指数:0.00(0.00,0.02)比0.05(0.02,0.09),触发延迟次数(次/min):0.00(0.00,0.58)比0.67(0.33,1.58),触发延迟指数:0.00(0.00,0.02)比0.05(0.02,0.09),吸呼切换提前次数(次/min):0.00(0.00,0.33)比0.33(0.08,1.00),吸呼切换提前指数:0.00(0.00,0.01)比0.02(0.00,0.05),吸呼切换延迟次数(次/min):0.00(0.00,0.00)比1.17(0.00,4.83),吸呼切换延迟指数:0.00(0.00,0.00)比0.07(0.00,0.25),均n P 0.1: 37.50% (6/16) vs. 93.75% (15/16), both n P < 0.01]. There was no significant difference in asynchronous time or arterial blood gas analysis between the two modes. There were significant increases in variances of peak airway pressure (Ppeak) and expiratory tidal volume (VTe) during NAVA mode ventilation as compared with PSV mode ventilation [Ppeak coefficient of variation (CV%): 11.25 (7.12, 15.17)% vs. 0.00 (0.00, 2.82)%, VTe CV%: (8.93±5.53)% vs. (4.71±2.61)%, both n P < 0.05].n Conclusions:Compared with PSV mode, NAVA mode can reduce the occurrence of patient-ventilator asynchronous events, reduce the AI and the occurrence of serious patient-ventilator asynchronous events, so as to improve the patient-ventilator interaction. NAVA and PSV modes can achieve the same gas exchange effect. At the same time, NAVA mode has potential advantages in avoiding insufficient or excessive ventilation support, diaphragm protection and prevention of ventilator-induced lung injury.