摘要
目的 探讨俯卧位通气在主动脉夹层术后低氧血症患者中的临床应用效果.方法 选择2018年1月至2019年2月在深圳市人民医院心脏大血管外科接受手术治疗的20例主动脉夹层患者作为研究对象,根据随机数表法分为观察组和对照组,每组10例,对照组患者予常规仰卧位机械通气治疗,观察组则间断给予俯卧位机械通气,观察通气治疗前及24 h后平均动脉压(MBP)、心率(HR),以及动脉血氧分压(PaO2)、经皮氧饱和度(SpO2)、氧合指数(OI),同时比较两组机械通气时间和住院时间等指标.结果 通气治疗24 h后,观察组患者的动脉血PaO2、SpO2、OI分别为(84.8±4.8)mmHg、(95.2±3.7)%、218.2±20.4,均明显高于对照组的(80.1±3.2)mmHg、(91.4±4.2)%、194.2±17.8,差异均有统计学意义(P<0.05);通气治疗24 h后,两组患者的MAP均明显上升,HR明显降低,分别与其治疗前比较差异均有统计学意义(P>0.05),但是两组之间比较差异无统计学意义(P>0.05);观察组患者的机械通气及住院时间分别为(2.2±0.7)d、(6.6±1.3)d,均明显短于对照组的(4.3±1.2)d、(8.7±2.1)d,差异均有统计学意义(P<0.05).结论 主动脉夹层术后低氧血症患者应用俯卧位通气治疗可以有效改善患者的氧合状况,有效缩短机械通气时间及住院时间,且不影响患者血流动力学的稳定.
Objective To investigate the application effect of prone position ventilation on hypoxemia after aortic dissection.Methods Twenty patients with aortic dissection who underwent surgical treatment in Department of Cardiovascular Surgery,Shenzhen People's Hospital from January 2018 to February 2019 were selected as the research objects.According to the random number table,the patients were divided into observation group and control group,with 10 patients in each group.The control group was treated with conventional supine mechanical ventilation.The observation group was treated with prone mechanical ventilation intermittently.The mean arterial pressure(MBP)and heart rate(HR)were observed before and 24 hours after ventilation.The arterial partial pressure of oxygen(PaO2),percutaneous oxygen saturation(SpO2),oxygenation index(OI),mechanical ventilation time,and hospitalization time were compared between the two groups.Results At 24 hours after ventilation,PaO2,SpO2,and OI in arterial blood of the observation group were(84.8±4.8)mmHg,(95.2±3.7)%,and 218.2±20.4,respectively,which were significantly higher than(80.1±3.2)mmHg,(91.4±4.2)%,and 194.2±17.8 of the control group(P<0.05).After 24 hours ventilation treatment,MAP increased significantly and HR decreased significantly(P<0.05),but there was no significant difference between the two groups(P>0.05).The duration of mechanical ventilation and hospitalization time in the observation group was(2.2±0.7)d,(6.6±1.3)d,significantly shorter than(4.3±1.2)d,(8.7±2.1)d in the control group(P<0.05).Conclusion Prone position ventilation can effectively improve the oxygenation status of patients with hypoxemia after aortic dissection,shorten the duration of mechanical ventilation and hospitalization time,and do not affect the stability of hemodynamics.
作者
曾碧茹
陈月儿
李妮
ZENG Bi-ru;CHEN Yue-er;LI Ni(Department of Cardiovascular Surgery,Shenzhen People's Hospital,Shenzhen 518020,Guangdong,CHINA)
出处
《海南医学》
CAS
2020年第6期708-710,共3页
Hainan Medical Journal
关键词
主动脉夹层
低氧血症
俯卧位
机械通气
氧合指数
Aortic dissection
Hypoxemia
Prone position
Mechanical ventilation
Oxygenation index
