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<fieldset class="" style=" max-width: 100%; min-width: 0px; color: rgb(62, 62, 62) ; ; ; ; ; ; ; ; ; ; ; ; "><section class="" style="padding: 10px; max-width: 100%; box-sizing: border-box; border-width: 1px; border-style: solid; border-color: rgb(192, 200, 209); font-size: 1em; font-family: inherit; font-weight: inherit; text-align: inherit; text-decoration: inherit; color: rgb(51, 51, 51); background-color: rgb(239, 239, 239); word-wrap: break-word !important;"><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;">对于一些呼吸存在困难或者异常的人们,可以借助呼吸机来进行辅助呼吸,减轻不适感。在ICU护理中最常用的呼吸机，我们需要知道参数设置和使用方式，大家一起看看吧——<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /></p></section></fieldset><fieldset class="" style=" max-width: 100%; min-width: 0px; color: rgb(62, 62, 62) ; ; ; ; ; ; ; ; ; ; ; ; "><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">一、呼吸机参数的设置和调节</span></strong></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、呼吸频率：</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">8-18</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">次</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">/</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">分，一般为</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">12</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">次</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">/</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">分。</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">COPD</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">及</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">ARDS</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">者例外。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、潮气量：</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">8-15ml/kg</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">体重，根据临床及血气分析结果适当调整。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">3</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、吸</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">/</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">呼比：一般将吸气时间定在</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">，吸</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">/</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">呼比以</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">：</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2-2.5</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">为宜，限制性疾病为</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"> 1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">：</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1-1.5</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">，心功能不全为</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">：</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1.5</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">，</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">ARDS</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">则以</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1.5-2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">：</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">为宜（此时为反比呼吸，以呼气时间定为</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">4</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、吸气流速（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">Flow</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">:</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">成人一般为</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">30-70ml/min</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">。安静、入睡时可降低流速；发热、烦躁、抽搐等情况时要提高流速。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">5</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、吸入氧浓度（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">FiO2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）：长时间吸氧一般不超过</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">50%-60%</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">6</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、触发灵敏度的调节：通常为</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">0.098-0.294kPa(1-75pxH2O),</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">根据病人自主吸气力量大小调整。流量触发者为</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">3-6L/min</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">7</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、吸气暂停时间：一般为</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">0-0.6s</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">，不超过</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1s</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">8</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">PEEP</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">的调节：当</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">FiO2>60%,PaO2<8.00kPa(1500pxH2O)</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">时应加</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">PEEP</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">。临床上常用</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">PEEP</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">值为</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">0.29-1.18kPa(3-12 cmH2O),</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">很少超过</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1.47kPa(375pxH2O).</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">9</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、报警参数的调节：不同的呼吸机报警参数不同，根据既要安全，又要安静的原则调节。压力报警：主要用于对病人气道压力的监测，一般情况下，高压限设定在正常气道高压（峰压）上</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">0.49-0.98kPa(5-10 cmH2O),</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">低压下限设定在能保持吸气的最低压力水平。</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">FiO2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">：一般可高于或低于实际设置</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">FiO2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">的</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">10%-20%.</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">潮气量：高水平报警设置与所设置</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">TV</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">和</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">MV</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">相同；低水平报警限以能维持病人生命的最低</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">TV</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">MV</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">水平为准。</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">PEEP</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">或</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">CPAP</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">报警：一般以所应用</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">PEEP</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">或</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">CPAP</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">水平为准。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">二、呼吸机各种报警的意义和处理</span></strong></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、气道高压</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">high airway pressure</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">：</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）原因：病人气道不通畅（呼吸对抗）、气管插管过深插入右支气气管、气管套管滑入皮下、人机对抗、咳嗽、肺顺应性低（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">ARDS</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、肺水肿、肺纤维化）、限制性通气障碍（腹胀、气胸、纵隔气肿、胸腔积液）</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）处理：听诊肺部呼吸音是否存在不对称、痰鸣音、呼吸音低；吸痰；拍胸片排除异常情况；检查气管套管位置；检查管道通畅度；适当调整呼吸机同步性；使用递减呼吸机同步性；使用递减流速波形；改用压控模式；使用支气管扩张剂；使用镇静剂。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、气道低压</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">Low airway pressure</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">原因：管道漏气、插管滑出、呼吸机参数设置不当</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">处理：检查漏气情况；增加峰值流速或改压力控制模式；如自主呼吸好，改</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">PSV</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">模式；增加潮气量；适当调整报警设置。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">3</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、低潮气量</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">Low tidal volume</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（通气不足）：</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）原因</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">*</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">低吸气潮气量：潮气量设置过低、报警设置过高、自主呼吸模式下病人吸气力量较弱、模式设置不当、气量传感器故障。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">*</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">低呼气潮气量：管道漏气、其余同上。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）处理：检查管路以明确是否漏气；如病人吸气力量不足可增加</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">PSV</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">压力或改</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">A/C</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">模式；根据病人体重设置合适的报警范围；用模拟肺检查呼吸机送气情况；用潮气量表监测送气潮气量以判断呼吸机潮气量传感器是否准确。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">4</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、低分钟通气量</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">Low minute volume</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（通气不足）</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）原因：潮气量设置过低、通气频率设置过低、报警设置过高、自主呼吸模式下病人通气不足、管道漏气。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）处理：排除管道漏气；增加辅助通气参数；如自主呼吸频率不快可用</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">MMV</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">模式并设置合适的每分钟通气量；适当调整报警范围。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">5</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、高分钟通气量</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">High minute volume</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（过度通气）</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）原因：病人紧张烦躁、有严重缺氧状况、呼吸机通气参数设置过高、呼吸机误触发导致高通气频率。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）处理：排除机器原因可使用镇静剂甚至肌松剂以防止病人的过度通气；改善病人的氧合，可增加氧浓度或加用</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">PEEP</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">；合理调整通气参数；如有误触发可降低触发灵敏度，关闭流速触发，检查呼气阀是否漏气。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">6</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、呼吸反比</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">inverse I:E</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）原因：吸气时间过长（送气流速过低、潮气量过大、气道阻力高），呼气时间过短，呼吸频率过高。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）增加吸气流速；减少压控模式的吸气时间；改善气道的通畅度；降低呼吸频率；如需要反比通气可关闭反比通气报警。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">7</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、窒息</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">1</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）原因：病人自主呼吸过弱、病人出现呼吸暂停、气道漏气。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">（</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">）处理：提高触发灵敏度；增加通气频率；改</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">A/C</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">或</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">SIMV</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">模式；检查气道漏气情况。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">8</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">、呼吸机工作异常</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">处理：立即脱离病人，改用呼吸皮囊过渡；用模肺检查呼吸机送气情况，可关闭机器再打开，观察故障是否依然存在；可做机器自检以判断故障原因</span><span style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;">;</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">原则上可能有故障的呼吸机不能给病人使用；通知维修工程师。</span></p><p style="max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">三、 常用的机械通气方式-</span></strong></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></strong></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">1. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">间歇正压呼吸（intermittent positive pressure ventilation,IPPV）：最基本的通气方式。吸气时产生正压，将气体压入肺内，靠身体自身压力呼出气体。</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">2. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">呼气平台(plateau)：也叫吸气末正压呼吸(endinspiratory positive pressure breathing,EIPPB),吸气末，呼气前，呼气阀继续关闭一段时间，再开放呼气，这段时间一般不超过呼吸周期的5%，能减少VD/VT（死腔量/潮气量）-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">3. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">呼气末正压通气（positive end expiratory pressure,PEEP）：在间歇正压通气的前提下，使呼气末气道内保持一定压力，在治疗呼吸窘迫综合征、非心源性肺水肿、肺出血时起重要作用。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">4. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">间歇指令通气（intermittent mandatory ventilation,IMV）、同步间歇指令通气（synchronized intermittent mandatory ventilation,SIMV）：属于辅助通气方式，呼吸机管道中有持续气流，（可自主呼吸）若干次自主呼吸后给一次正压通气，保证每分钟通气量，IMV的呼吸频率chengren一般小于10次/分，儿童为正常频率的1/2~1/10-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">5. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">呼气延迟，也叫滞后呼气(expiratory retard)：主要用于气道早期萎陷和慢性阻塞性肺疾患，如哮喘等，应用时间不宜太久。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">6. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">深呼吸或叹息（sigh）-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">7. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">压力支持(pressure support)：自主呼吸基础上，提供一定压力支持，使每次呼吸时压力均能达到预定峰压值。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">8. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">气道持续正压通气(continue positive airway pressure,CPAP)：除了调节CPAP旋钮外，一定要保证足够的流量，应使流量加大3~4倍。CPAP正常值一般4~300px水柱，特殊情况下可达15厘米水柱。（呼气压4厘米水柱）。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">四、 呼吸机与人体的连接：-</span></strong></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">情况紧急或者估计插管保留时间不会太长、新生儿、早产儿、一般经口插管。其他情况可以选经鼻插管或者是气管切开。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">五、呼吸机工作参数的调节：</span></strong></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">四大参数：潮气量、压力、流量、时间（含呼吸频率、吸呼比）。</span><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">-</span></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">1. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">潮气量：潮气输出量一定要大于人的生理潮气量，生理潮气量为6~10毫升/公斤，而呼吸机的潮气输出量可达10~15毫升/公斤，往往是生理潮气量的1~2倍。还要根据胸部起伏、听诊两肺进气情况、参考压力二表、血气分析进一步调节。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">2. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">吸呼频率：接近生理呼吸频率。新生儿40~50次/分，婴儿30~40次/分，年长儿20~30次/分，chengren16~20次/分。潮气量*呼吸频率=每分通气量-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">3. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">吸呼比：一般1：1.5~2，阻塞性通气障碍可调至1：3或更长的呼气时间，限制性通气障碍可调至1：1。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">4. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">压力：一般指气道峰压（PIP），当肺部顺应性正常时，吸气压力峰值一般为10~20厘米水柱，肺部病变轻度：20~25厘米水柱；中度：25~30毫米水柱；重度：30厘米水柱以上，RDS、肺出血时可达60厘米水柱以上。但一般在30以下，新生儿较上述压力低5厘米水柱。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">5. PEEP</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">使用IPPV的患儿一般给PEEP2~3厘米水柱是符合生理状况的，当严重换气障碍时（RDS、肺水肿、肺出血）需增加PEEP，一般在4~10厘米水柱，病情严重者可达15甚至20厘米水柱以上。当吸氧浓度超过60%（FiO2大于0.6）时，如动脉血氧分压仍低于80毫米汞柱，应以增加PEEP为主，直到动脉血氧分压超过80毫米汞柱。PEEP每增加或减少1~2毫米水柱，都会对血氧产生很大影响，这种影响数分钟内即可出现，减少PEEP应逐渐进行，并注意监测血氧变化。PEEP数值可从压力二表指针呼气末的位置读出。（有专门显示的更好）-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">6. </span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">流速：至少需每分种通气量的两倍，一般4~10升/分钟。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">六、根据血气分析进一步调节：</span></strong></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 0, 0); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">首先要检查呼吸道是否通畅、气管导管的位置、两肺进气是否良好、呼吸机是否正常送气、有无漏气。-</span></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">调节方法：-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">1. PaO2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">过低时：（1）提高吸氧浓度（2）增加PEEP值（3）如通气不足可增加每分钟通气量、延长吸气时间、吸气末停留等。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">2. PaO2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">过高时：（1）降低吸氧浓度（2）逐渐降低PEEP值。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">3. PaCO2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">过高时：（1）增加呼吸频率（2）增加潮气量：定容型可直接调节，定压型加大预调压力，定时型增加流量及提高压力限制。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">4. PaCO2</span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">过低时：（1）减慢呼吸频率。可同时延长呼气和吸气时间，但应以延长呼气时间为主，否则将其相反作用。必要时可改成IMV方式。（2）减小潮气量：定容型可直接调节，定压型可降低预调压力，定时型可减少流量、降低压力限制。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">七、湿化问题：</span></strong></span><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">加温湿化：效果最好，罐中水温50~70摄氏度，标准管长1.25米，出口处气体温度30~35摄氏度，湿度98~99%。湿化液只能用蒸馏水。雾化器：温度低，刺激性大。病人较难接受。气管内直接滴注：特别是气道有痰痂阻塞时，滴注后反复拍背、吸痰，常能解除通气不良。具体方法：成年人每20~40分钟滴入0.45~0.9盐水2毫升，或以4~6滴/分的速度滴入，总量大于200毫升/天，儿童每20~30分钟滴入3~10滴，以气道分泌物稀薄、能顺利吸引、无痰痂为宜。人工鼻。略。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">八、吸氧浓度（FiO2）：</span></strong></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">一般机器氧浓度从21~100%可调。既要纠正低氧血症，又要防止氧中毒。一般不宜超过0.5~0.6，如超过0.6时间应小于24小时。目标：以最低的吸氧浓度使动脉血PaO2大于60毫米汞柱（8.0Kpa）。如给氧后紫绀不能缓解可加用PEEP。复苏时可用1.0氧气，不必顾及氧中毒。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">九、设定报警范围：</span></strong></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">气道压力上下限报警（一般为设定值上下30%）、气源压力报警、其他报警。</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">十、意外问题：</span></strong></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">呼吸机旁应备有复苏器，或者其他简易人工气囊，气囊和气管导管之间的接头也应备好。注意防止脱管、堵管、呼吸机故障、气源和电源故障。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">十一、常见合并症：</span></strong></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">压力损伤、循环障碍、呼吸道感染、肺不张、喉、气管损伤。-</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; color: rgb(0, 112, 192); box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">十二、呼吸机的撤离：</span></strong></span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;">逐渐降低吸氧浓度，PEEP逐渐降至3~4厘米水柱，将IPPV改为IMV（或SIMV）或压力支持，逐渐减少IMV或支持压力，最后过渡到CPAP或完全撤离呼吸机，整个过程需严密观察呼吸、血气分析情况。拔管指征：自主呼吸与咳嗽有力，吞咽功能良好，血气分析结果基本正常，无喉梗阻，可考虑拔管。气管插管可一次拔出，气管切开者可经过换细管、半堵管、全堵管顺序，逐渐拔出-。</span></p><p style="margin-top: auto; margin-bottom: auto; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 宋体; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p></fieldset><p><br /></p><p><br /></p><p style="white-space: normal;"><span style="color: rgb(62, 62, 62); font-family: Arial, Verdana, sans-serif; line-height: 1.75em; text-indent: 0em; max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">地址：广州市天河区银利街银利茶叶博览中心E栋4楼E4030室 </span><span style="color: rgb(62, 62, 62); font-family: Arial, Verdana, sans-serif; text-indent: 0em; max-width: 100%; font-size: 14px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;"> </span></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 14px; line-height: 1.75em; box-sizing: border-box !important; word-wrap: break-word !important;">邮编：510507</span></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">电话：(+86)020-8722 8723 8764 5360 8764 2943 </span></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">传真：020-8722 8623</span></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">全国统一免费服务热线：400-020-6788</span></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">微信公众帐号：</span></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><img data-ratio="1" src="http://mmbiz.qpic.cn/mmbiz/dx3KibwtDhvfCZvZq5PcthnDKlnnq3AalhbichW77J3B70osicTickklZybNKUZqc44DZ0oaWaHm2p0TaA9478icwPg/640?wx_fmt=jpeg" data-type="jpeg" data-w="120" width="auto" style="box-sizing: border-box !important; word-wrap: break-word !important; visibility: visible !important; width: auto !important;" /></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">维修咨询：QQ: 712638 404</span></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">设备咨询: QQ: 712638 405</span></p><p style="font-size: 16px; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); line-height: 24.381px; text-align: justify; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="font-size: 14px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; text-indent: 0em;">软件咨询：QQ: 712638 406</span><br /></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; background-color: rgb(255, 255, 255); box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">配件咨询：QQ: 712638 407</span></p><p style="text-indent: 0em; white-space: normal; max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; font-family: Arial, Verdana, sans-serif; line-height: 1.75em; 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font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">电子邮箱：service@yiliaoshebeiweixiu.com</span></p><p><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p><br /></p>
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发表于 2020-10-19 23:26:07