俯卧位通气对中重度急性呼吸窘迫综合征患者氧合及血流动力学的影响  

Effects of Prone Position Ventilation on Oxygenation and Hemodynamics in Patients with Moderate or Severe Acute Respiratory Distress Syndrome

作　　者：张勇[1] 

机构地区：[1]河南宏力医院重症医学科,河南长垣453400

出　　处：《现代诊断与治疗》2017年第24期4514-4516,共3页Modern Diagnosis and Treatment

摘　　要：目的观察俯卧位通气对中重度急性呼吸窘迫综合征(ARDS)患者氧合及血流动力学的影响。方法对14例中重度ARDS患者实施了俯卧位通气。俯卧位前后监测动脉血氧分压(PaO_2)、氧合指数(PaO_2/FiO_2)、动脉血二氧化碳分压(PaCO_2)、平均动脉压(MAP)、心率(HR)、多巴胺或去甲肾上腺素用量。结果 14例ARDS患者PaO_2、PaO_2/FiO_2在实施俯卧位后有显著上升,差异有统计学意义(P<0.01),而PaCO_2、MAP、HR、多巴胺或去甲肾上腺素用量无明显变化(P>0.05)。发生腹部切口裂开、感染1例,轻度压疮3例,ICU留治时间12.4±9.6d,死亡5例,总病死率35.7%。无管道或引流管等脱出病例。结论俯卧位通气明显改善中重度急性呼吸窘迫综合征患者氧合,对血流动力学无明显影响。并发症发生率较低。Objective To observe the effects of prone position ventilation on oxygenation and hemo- dynamic in patients with moderate or severe acute respiratory distress syndrome.Methods 14 pa- tients with moderate or severe acute respiratory distress syndrome（ARDS） were ventilated on prone position.The arterial partial pressure of oxygen（PaO2）,Oxygenation index（PaO2/FiO2）,The arterial par- tial pressure of carbon dioxide （PaCO2）,mean arterial pressure （MAP）,heart rate （HR）and dosage of dopamine or norepinephrine were monitored before and after prone position ventilation.Results These 14 patients had significant increased in Pa02 and PaO2/FiO2,The difference was statistically significant （P〈0.01）,But PaCO2,MAP,HR,dosage of dopamine and norepinephrine had no obvious change（P〉0.05）.One patient complicated with split and infection of abdominal incision.There were 3patients with pressure ulcers.The time of stay in the ICU is （12.4Prone Position Ventilation;Acute Respiratory Distress Syndrome;Oxygenation;Hemody- namics9.6）days.5 cases died,and totalmortality 35.7%.There was no catheter or drainage tube slippage.Conclusion The prone positionventilation can improve oxygenation in patients with moderate or severe ARDS,but did＇t influencehemodynamics obviously.The incidence of complications were relatively low.

关 键 词：俯卧位通气 急性呼吸窘迫综合征 氧合 血流动力学 

分 类 号：R563.8[医药卫生—呼吸系统]