俯卧位通气在心脏外科术后顽固性低氧血症中的应用及效果观察  

Application of prone position ventilation in refractory hypoxemia after cardiac surgical operation and observation of its effect

作　　者：罗艳[1] 

机构地区：[1]广东省茂名市人民医院外科ICU,茂名市525000

出　　处：《护理实践与研究》2017年第3期31-33,共3页Nursing Practice and Research

摘　　要：目的:研究俯卧位通气在心脏外科术后顽固性低氧血症中的应用及疗效。方法:选取2014年1月~2015年6月入院诊治的行心脏外科手术后发生顽固性低氧血症患者62例作为研究对象,对其实行早期俯卧位通气,观察治疗前后患者呼吸参数与血流动力学指标变化。结果:不同时间节点患者的动脉血氧分压、吸入气氧浓度、氧合指数、呼吸指数、静态肺顺应性差异具有统计学意义(P<0.05),而肺泡-动脉氧分压差则在不同时间无统计学意义(P>0.05);俯卧位通气0.5,2 h与转为仰卧位1 h后动脉血氧分压、氧合指数与静态肺顺应性均较俯卧位前升高,而呼吸指数下降,差异有统计学意义(P<0.05);且动脉血氧分压在改为仰卧位1 h后较之俯卧位通气0.5,2 h时下降差异有统计学意义(P<0.05)。收缩压在不同时间不尽相同,且俯卧位0.5 h后较之俯卧位前显著升高(P<0.05);心率与中心静脉压在各个时段的变化并不明显(P>0.05)。结论:俯卧位通气对于心脏外科手术后顽固性低氧血症患者,可有效改善患者的氧合状况,同时对血流动力学并无不良影响。ObjectiveTo research the application and curative effect of prone position ventilation in refractory hypoxemia after cardiac surgical operation.Methods：Selected 62 patients receiving refractory hypoxemia after cardiac surgical operation receiving diagnosis and treatment in our hospital from January2014 to June 2015, and early prone ventilation was conducted for them, and the change of patients＇ respiratory parameters and haemodynamics indicatorswas observed before and after operation. Results：The difference in patients＇ arterial partial pressure of oxygen, inhaled oxygen concentration, oxygenationindex, respiratory index and static lung compliance in different periods of time was statistically significant （ P 〈 0.05 ） , while the alveolar - arterial oxygentension difference was not statistically significant in different periods of time （ P 〉 0.05 ） ; the arterial partial pressure of oxygen, oxygenation index and stat-ic lung compliance increased compared with those before prone position 0.5 and 2 h after prone position ventilation and 2 h after transformation into supineposition, while the respiratory index decreased, and the difference was statistically significant （ P 〈 0.05 ） ; the arterial partial pressure of oxygen decreased1 h after transformation inte. supine position compared with that 0.5 and 2 h after prone position, and the difference was statistically significant （ P 〈 0.05 ）.The systolic pressure was different in different periods of time, and increased significantly 9.5 h after prone position compared with that before prone position（P 〈 0.05 ）, and the change of heart rate and central venous pressure was not significant in various periods （P 〉 0.05 ）. Conclusion：The prone positionventilation could effectively improve the oxygenation status of patients with refractory hypoxemia after cardiac surgical operation, without adverse intlunce onthe haemodynamics.

关 键 词：俯卧位通气 心脏外科 顽固性低氧血症 护理 

分 类 号：R473.6[医药卫生—护理学]