急性肺损伤/急性呼吸窘迫综合征患者侧卧位通气与俯卧位通气的对比观察  

Comparison of lateral position and prone position ventilation in patients with acute lung injury/acute respiratory distress syndrome

作　　者：吴威士[1] 罗敏[1] 杨翠华[1] 

机构地区：[1]广东省韶关市粤北人民医院ICU,512026

出　　处：《中华结核和呼吸杂志》2004年第9期589-592,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　评价侧卧位通气和俯卧位通气对急性肺损伤 /急性呼吸窘迫综合征 (ALI/ARDS)患者的临床疗效 ,并对两种通气方法进行对比观察。方法　以 2 0 0 2年 3月为分界线 ,将 2 4例患者分为两组分别施行侧卧位通气 (2 0 0 2年 4月后 13例 )和俯卧位通气 (2 0 0 2年 3月前 11例 ) ,监测体位改变前、后的呼吸循环指标并分别进行比较。结果　体位改变 1h后 ,两组患者动脉血氧分压(PaO2 )均升高 ,侧卧位组由 (10 3± 12 )mmHg(1mmHg =0 .133kPa)上升到 (12 6± 13)mmHg,差异有显著性 (P <0 0 1) ;俯卧位组由 (87± 19)mmHg上升到 (119± 15 )mmHg(P <0 0 1)。以PaO2 升高 10mmHg为治疗有效标准 ,治疗有效率侧卧位组 6 1 5 % ,俯卧位组 6 3 6 % ,两组比较差异无显著性 (P >0 0 5 )。结论　作为ALI/ARDS的辅助治疗手段 ,侧卧位通气与俯卧位通气的治疗有效率接近 ,但侧卧位实施更容易 ,护理更方便 ,值得临床进一步探讨。Objective To evaluate the clinical result of lateral position ventilation and prone position ventilation in acute lung injury/acute respiratory distress syndrome(ALI/ARDS) patients. Methods Twenty-four patients were allocated to two groups,with one group(n=13) receiving lateral position ventilation after April 2002,and the other(n=11) received prone position ventilation before March 2002. Respiratory and circulatory indices were monitored after position changes and compared between the two groups. Results One hour after position change PaO_2 was elevated in both groups;in the lateral position group from (103±12)mm Hg to (126±13)mm Hg(P<0.01),and in the prone position group from (87±19)mm Hg to (119±15)mm Hg(P<0.01). If a 10 mm Hg increase was regarded as the standard of treatment effectiveness,then the effective rate in the lateral position group was 61.5% and in the prone position group was 63.6%,the difference being not significant. Conclusion As auxiliary means in the treatment of ALI/ARDS,lateral position and prone position ventilation showed similar effects,but the lateral position was more convenient for practice and medical care,thus needs further investigation.

关 键 词：侧卧位 俯卧位通气 患者 对比观察 急性呼吸窘迫综合征 急性肺损伤 体位改变 结论 效标 显著性 

分 类 号：R563.8[医药卫生—呼吸系统]