俯卧位通气治疗在高原重度急性呼吸窘迫综合征中的应用效果  

The effective application of ventilation at prone position on patients with severe acute respiratory distress syndrome at high altitude

作　　者：孙晓林 潘世琴[1] 王皓[1] 韩进海 张霞[1] Sun Xiaolin;Pan Shiqin;Wang Hao;Han Jinhai;Zhang Xia(ICU of Qinghai Province People′s Hospital,Xi′ning 810007,China)

机构地区：[1]青海省人民医院ICU,西宁810007

出　　处：《中国实用护理杂志》2019年第9期699-703,共5页Chinese Journal of Practical Nursing

摘　　要：目的探讨俯卧位通气治疗对高原重度急性呼吸窘迫综合征(ARDS)患者的应用效果。方法选择青海省人民医院重症医学科2016年2月至2018年2月收治的19例重度ARDS患者,监测俯卧位通气治疗前后12、24、48、72h后患者的一般指标:心率、呼吸、平均动脉压(MAP);血气指标:动脉血氧分压(PaO2)、吸入氧浓度(FiO2)、二氧化碳分压(PCO2)、血氧饱和度(SpO2)、氧合指数(PaO2/FiO2)、pH值;呼吸力学指标:肺顺应性、呼气末正压通气(PEEP)等指标。结果与俯卧位通气治疗前相比,在俯卧位通气治疗后12、24、48、72h患者的FiO2和PEEP逐渐下降,差异有统计学意义(F=32.30、24.73,P<0.05);心率、MAP、呼吸、PaO2、PCO2、SPO2、PaO2/FiO2、pH、肺顺应性等指标均改善,差异有统计学意义(F=3.64~392.52,P<0.05)。结论ARDS患者行俯卧位通气治疗并辅以恰当的护理干预,可有效改善高原重度ARDS患者的氧合状况及生命体征,具有临床应用价值。Objective To explore the effective application of ventilation at prone position on patients with severe acute respiratory distress syndrome(ARDS)at high altitude.MethodsA total of 19 severe ARDS patients in ICU of Qinghai Province People's Hospital were enrolled from February in 2016 to February.in 2018,all of them ventilated at the prone position,several indicators were assessed:heart rate(HR),respiratory(R),mean arterial pressure(MAP);blood gas indicators:arterial oxygen partial pressure(PaO2),inhaled oxygen concentration(FiO2),carbon dioxide partial pressure(PaCO2),blood oxygen saturation(SpO2),oxygenation index(PaO2/FiO2),PH,lung compliance,PEEP and so on,which assessed before and 12h,24h,48h,72h after the ventilation.ResultsFiO2 and PEEP significantly declined at 12 h,24 h,48 h,72 h after ventilation at the prone position.HR,MAP,R,PaO2,PaCO2,SPO2,PaO2/FiO2,pH and lung compliance significantly improved(F=32.30,24.73,P<0.05).ConclusionsIt was an effective method for ARDS patients to improve the oxygenation status and vital signs at the plateau with ventilation used at the prone position and probably nursing intervention,which have clinical application value.

关 键 词：呼吸窘迫综合征 成人 高原 俯卧位通气 

分 类 号：R473.5[医药卫生—护理学]