急性呼吸窘迫综合征患者侧卧位通气与俯卧位通气的临床疗效观察被引量：26

Comparison of lateral position ventilation and prone position ventilation in the patients with acute respiratory distress syndrome

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摘要目的评价侧卧位通气和俯卧位通气对急性呼吸窘迫综合征(ARDS)患者的临床疗效,并对两种体位通气方法进行对比观察。方法将ICU 20Q5年收治的23例ARDS患者随机分为两组,分别施行侧卧位通气(15例)和俯卧位通气(8例),监测仰卧位时,体位改变后1、2、4h及转复为仰卧位后1h的呼吸循环指标,并分别进行比较。结果体住改变后1、2、4 h及转复为仰卧位后1h,两组患者动脉血氧分压、氧舍指数均较仰卧位时升高(P＜0．05),心率、平均动脉压、气道峰压及动脉血二氧化碳分压与仰卧位时比较差异无统计学意义(P＞0．05)。以氧分压升高10mmHg为有效标准,治疗有效率侧卧位组73．3%,俯卧位组66．7%,两组比较差异无统计学意义(P＞0．05)。结论作为ARDS机械通气治疗手段,侧卧位通气与俯卧位通气治疗的有效率接近,但侧卧位实施更容易,护理更方便,并发症少,值得临床进一步探讨。 Objective To evaluate the clinical efficacy of lateral position ventilation and prone position ventilation in the patients with acute respiratory distress syndrome. Methods 23 patients were randomly divided into two groups： lateral position ventilation group and prone position ventilation group. Respiratory and circulatory indices were monitored supine position, at 1 ,2,4 hours after position changes and 1 hour after returning to supine position, and also compared between the two groups. Results Compared with supine positiont PaO2 and oxygenation index increased at 1 ,2 ,4 hour after position changes and 1 hour after returning to supine position in two groups, and there were statistical differences（ P 〈 0.05） ;There were no statistical differences in HR, MAP, PaCO2 and peak inspiratory pressure （PIP） in two groups（ P 〉 0.05）. If a 10 mm Hg increase was regarded as the standard of treatment effectiveness, the effective rate in the lateral position ventilation group was 73.3% and in the prone position ventilation group was 66.7%. There was no statistical difference （ P 〉 0. 05 ）. Conclusion As a means in the treatment of acute respiratory distress syndrome, lateral position ventilation and prone position ventilation showed similar effects, but the lateral position is more convenient for the practice and medical care, thus needs further investigation.

作者张丽娜艾宇航

机构地区中南大学湘雅医院ICU

出处《中国急救医学》 CAS CSCD 北大核心 2006年第12期908-910,共3页 Chinese Journal of Critical Care Medicine

关键词急性肺损伤呼吸窘迫综合征侧卧位通气俯卧位通气 Acute lung injury Acute respiratory distress syndrome（ ARDS） Lateral position ventilation Prone position ventilation

分类号 R563.8 [医药卫生—呼吸系统]

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