摘要
目的研究俯卧位肺复张在重症肺部感染出现低氧血症患者中的应用效果。方法选取2013年4月至2015年4月本院接诊的75例重症肺部感染合并低氧血症的患者进行研究，随机分为两组，观察组45例患者实施俯卧位肺复张治疗，对照组30例实施仰卧位肺复张治疗。分别检测两组患者肺复张前后基础指标、血流动力学及氧合指标的变化情况，并对肺复张后不良反应发生情况进行比较分析。结果肺复张前，两组患者的各项生命体征差异均无统计学意义（均P〉0．05）；肺复张后，两组患者的心率（HR）及平均动脉压（MAP）均有所下降，但与复张前比较差异无统计学意义（P〉0．05），血氧饱和度（Sp02）和氧合指数（PaO2／FiO2）水平均明显升高（P〈0．05）；观察组SpO2和PaO2／FiO2水平明显高于对照组（P〈0．05）。肺复张前，两组患者的血流动力学各项指标差异均无统计学意义（均P〉0．05）；肺复张后，两组患者的中心静脉压（CVP）、每搏指数（SVI）及全心射血分数（GEF）水平均明显降低，全身血管阻力（SVRI）水平明显升高（P〈0．05）。观察组患者肺复张后不良反应发生率为4．44％，对照组为17．78％，差异有统计学意义（Х^2=4．9363，P=0．0442）。结论俯卧位和仰卧位肺复张均能显著改善患者的血氧及血流动力学状况，但俯卧位肺复张的治疗效果及安全性均较高。
Objective To study the application effect of pulmonary reexpansion in the prone position in patients with hyoxemia caused by severe pulmonary infection. Methods 75 cases of hyoxemia caused by severe pulmonary infection in our hospital from April 2013 to April 2015 were randomly divided into two groups. 45 patients in the observation group were treated by pulmonary reexpansion in the prone position, while 30 patients in the control group were treated by pulmonary reexpansion in the supine position. The changes of basic indexes, hemodynamies, and oxygenation indexes of the two groups were detected before and after pulmonary reexpansion, and the incidences of adverse reactions of the two groups were compared and analyzed. Results The vital signs of patients in the two groups had no statistically significant differences before pulmonary reexpansion （P〉0.05）; after pulmonary reexpansion, heart rate （HR） and mean arterial pressure （MAP） levels decreased in both two groups, but without statistically significant differences compared with those before pulmonary reexpansion （P〉0.05）; after pulmonary reexpansion, oxygen saturation （SpO2） and oxygen synthetic index （PaO2 / FiO2） levels significantly increased in both two groups （P〈0.05）, those in the observation group were significantly higher than those of the control group （P〈0.05）. The hemodynamic indicators of patients in the two groups had no statistically significant differences before pulmonary reexpansion （P〉0.05）; after pulmonary reexpansion, central venous pressure （CVP）, stroke volume index （SVI） and global ejection fraction （GEF） levels significantly decreased in both two groups, systemic vascular resistance index （SVRI） significantly increased （P〈0.05）. The incidence of adverse reactions after pulmonary reexpansion was 4.44% in the observation group and 17.78% in the control group, with statistically significant difference between the two groups （Х^2=4.936 3, P=0.044 2）. Conclusion Pulmonary reexpansion in the prone and supine position both can significantly improve blood oxygenation and hemodynamic status in patients, but the therapeutic effect and safety of pulmonary reexpansion in the prone position are higher.
作者
刘鑫
Liu Xin Xuchang(Central Hospital, Xuchang 461000, Chin)
出处
《国际医药卫生导报》
2018年第5期664-668,共5页
International Medicine and Health Guidance News
关键词
重症肺部感染
低氧血症
肺复张
俯卧位
血流动力学
Severe pulmonary infection
Hypoxemia
Pulmonary reexpansion
Prone position
Hemodynamics
