目的：探讨机械通气患者呼气末正压（PEEP）对膀胱压的影响。方法选取我院重症医学科机械通气且监测膀胱压的患者40例，将膀胱压正常＜1．47 kPa（15 cmH2 O）的患者23例作为A组，膀胱压增高≥1．47 kPa （15 cm H2 O ）的患者17例作为 B 组，采用自身对照法，观察患者在断开呼吸机及使用呼气末正压0 kPa （0 cmH2O）、0．294 kPa （3 cmH2O）、0．490 kPa（5 cmH2O）、0．981 kPa（10 cmH2O）和1．47 kPa（15 cmH2O）时的膀胱压变化。结果A组患者在不同呼气末正压时膀胱压的变化差异无统计学意义（P＞0．05）。B组患者在呼气末正压＞0．294 kPa（3 cmH2 O）时随着呼气末正压的增高膀胱压也会随之增高，差异有统计学意义（P＜0．05），呼气末正压为≤0．294 kPa（3 cmH2 O）时与断开呼吸机时测得的膀胱压比较，差异无统计学意义（P＞0．05）。结论膀胱压＜1．47 kPa（15 cm H2 O ）时，可保持呼吸机的呼气末正压正常调整，以保证患者的氧合，保障患者的安全。膀胱压≥1．47 kPa（15 cmH2 O）时，应保持呼吸机的呼气末正压≤0．294 kPa（3 cmH2 O）的水平，以保证患者的氧合，保障患者的安全。%Objective To study the effect of mechanical ventilation with positive end expiratory pressure(PEEP) pressure on the bladder pressure .Method 40 patients with mechanical ventilation in intensive care unit was selected and divided into two group according to the bladder pressure:23 patients in group A with normal bladder pressure <1 .47 kPa(15 cmH2O) ,17 patients in group B with increased bladder pressure ≥1 .47 kPa (15 cmH2O) .Using self‐control ,the bladder pressure changes while PEEP 0 kPa(0 cmH2O)、0 .294 kPa(3 cmH2O)、0 .490 kPa (5 cmH2O)、0 .981 kPa(10 cmH2O)and 1 .47 kPa(15 cmH2O) ventilator disconnecting was measured and com‐pared .Result There was no significant difference in bladder pressure between A group at different end expiratory pressure (P>0 .05) .At the end of the positive end expiratory pressure ,the B group had a statistically significant difference >0 .294 kPa(3 cmH2 O) with the increase of bladder pressure at the end of positive end expiratory pres‐sure ≤ 0 .294 kPa (3 cmH2 O ) ( P < 0 .05 ) . Conclusion When bladder pressure was measured < 1 .47 kPa (15 cmH2 O ,) the positive end expiratory pressure was maintained to ensure the oxygenation and safety of the pa‐tients .When bladder pressure was measured and ≥1 .47 kPa(15 cmH2 O) ,the positive end expiratory pressure was maintained to ≤3 cmH2 O to ensure the oxygenation and safety of the patients .
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