仰卧位和俯卧位肺复张对重症肺炎患者治疗效果的比较  

Effects of prone and supine position ventilation combined with recruitment maneuver on patients with severe pneumonia

作　　者：于永福[1] 于湘友[1] 贾民[1] 

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830011

出　　处：《东南大学学报（医学版）》2014年第2期167-170,共4页Journal of Southeast University(Medical Science Edition)

基　　金：乌鲁木齐市科学技术计划项目(Y111310024)

摘　　要：目的:评价仰卧位、俯卧位肺复张对重症肺炎患者血流动力学、氧合的影响。方法:将90例重症肺炎患者随机分为仰卧位肺复张组、俯卧位肺复张组、仰卧位肺复张+俯卧位肺复张组。监测肺复张前、肺复张后5 min、复张后1 h血流动力学和氧合的变化。结果:两种体位下肺复张前和肺复张后5 min中心静脉压(CVP)、心脏指数(CI)均降低,差异均有统计学意义(P<0.05),但肺复张后1 h血流动力学指标已接近肺复张前;两种体位肺复张前后氧合指数(PaO2/FiO2)均升高,差异均有统计学意义(P<0.05),且俯卧位肺复张后1 h氧合改善程度较仰卧位肺复张后1 h明显。结论:仰卧位肺复张和俯卧位肺复张后的氧合指数明显高于肺复张前,俯卧位比仰卧位肺复张更能改善患者氧合,肺复张对血流动力学影响不明显。Objective： To explore the effects of prone and supine position ventilation combined with recruitment maneuver on patients with severe pneumonia .Methods：90 cases were randomly divided into three groups , including prone position group , supine position group , prone position combined supine position group .Results：Compared with data before recruitment maneuver , CI and CVP were decreased significantly after recruitment maneuver 5 minutes in＆amp;nbsp;both supine position and prone position group （P〈0.05）, then they returned to the base level an hour later ,but significant differences in PaO 2/FiO2 were found between before and after recruitment maneuver when patients ＆#39;position was changed , and it suggest that recruitment maneuver improved oxygenation more effectively in prone compared with supine position . Conclusions： Prone and supine position ventilation combined with recruitment maneuver significantly improves oxygenation in severe pneumonia patients ,but slightly changes hemodynamics .

关 键 词：重症肺炎 体位 肺复张 血流动力学 

分 类 号：R563.1[医药卫生—呼吸系统]