呼吸窘迫综合征患儿不同体位机械通气的临床效果观察  

Clinical effect of mechanical ventilation in different body position in children with respiratory distress syndrome

作　　者：刘显会 张罡[1] LIU Xianhui;ZHANG Gang(Department of Pediatrics,The First People′s Hospital of Yibin,Yibin 644000,China)

机构地区：[1]宜宾市第一人民医院儿科,四川宜宾644000

出　　处：《皖南医学院学报》2018年第6期547-550,共4页Journal of Wannan Medical College

基　　金：宜宾市卫生局科学技术计划基金资助项目(〔2014〕350号-21)

摘　　要：目的:探讨不同体位对急性呼吸窘迫综合征(ARDS)患儿机械通气临床效果的影响。方法:选择2015年11月~2017年10月宜宾市第一人民医院儿科PICU住院的62例行机械通气的ARDS患儿为研究对象,采用随机数字表法将患儿分为观察组和对照组,各31例。对照组予以常规仰卧位机械通气,观察组予以仰卧位和俯卧位体位变换机械通气。比较两组血气分析指标(PaCO_2、pH、PaO_2、SaO_2、PaO_2/FiO_2)、机械通气总时间、住PICU时间、28 d病死率和并发症。结果:通气后1、3 d观察组PaCO_2、PaO_2、PaO_2/FiO_2、SaO_2较对照组改善差异具有统计学意义(P<0.05);观察组机械通气总时间、住PICU时间、28 d病死率和并发症发生率低于对照组(P<0.05)。结论:不同体位机械通气能较好地改善ARDS患儿血气分析指标,提高氧合及预防并发症。Objective:To observe the clinical effect of mechanical ventilation in different body position in children with acute respiratory distress syndrome(ARDS).Methods:Sixty-two ARDS children undergoing mechanical ventilation in PICU in the First People′s Hospital of Yibin city were included from November 2015 to October 2017,and equally allocated to observational group and control group by random digital table.Children in the control group received mechanical ventilation by conventional supine position,whereas those in the observational group were treated in turn with supine and prone position.Then the two groups were compared regarding the blood gas test results(PaCO2,pH,PaO2,SaO2,PaO2/FiO2),mechanical ventilation time,length of PICU stay,fatality rate at 28 d and complications.Results:Children in the observational group had significantly better improvement of PaCO2,PaO2,PaO2/FiO2 and SaO2 in the 1st and 3rd day,as well as shortened ventilation time,reduced length of PICU stay,lower fatality rate at 28 d and complications than those in the control group(all P<0.05).Conclusion:Mechanical ventilation by different body position for ARDS children can improve their blood gas analysis index and oxygenation state as well as prevent complications.

关 键 词：急性呼吸窘迫综合征 仰卧位 俯卧位 血气分析 儿童 

分 类 号：R725.6[医药卫生—儿科]