俯卧位通气在复杂先天性心脏病患儿延迟关胸术后低氧血症的应用  

Application of Prone Ventilation in Children with Complex Congenital Heart Disease with Delayed Hypoxemia after Delayed Chest Closure

作　　者：刘伟[1] 郑丽红[1] 梁晓丽 李茹 韩冬 矫俊 郭红霞[1] LIU Wei;ZHENG Li-hong;LIANG Xiao-li;LI Ru;HAN Dong;JIAO Jun;GUO Hong-xia(Heart Comprehensive Ward,Dalian Children's Hospital,Dalian 116012,Liaoning,China)

机构地区：[1]大连市儿童医院心脏综合病房

出　　处：《医学信息》2020年第2期181-183,共3页Journal of Medical Information

摘　　要：目的探讨俯卧位通气在复杂先心病患儿延迟关胸术后低氧血症的应用效果。方法回顾性分析2017年1月~2018年12月我院行延迟关胸的34例复杂先天性心脏病患儿的临床资料,对低氧血症患儿实行俯卧位通气,比较第1次俯卧位通气前(T1)、俯卧位0.5 h(T2)、俯卧位1 h(T3)、俯卧位2 h(T4)患儿血气指标[氧分压(PaO2)、二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)、乳酸(Lac)]变化及生命体征[心率(HR)、动脉血压(ABP)、中心静脉压(CVP)、呼吸频率(RR)、血氧饱和度(SpO2)]变化。结果T2~T4时间点PaO2、SaO2均较T1升高,PaCO2、Lac均较T1下降,差异有统计学意义(P<0.05)。不同时间点HR、ABP、CVP、RR比较,差异无统计学意义(P>0.05);T2~T4时间点SpO2较T1升高,差异有统计学意义(P<0.05)。结论俯卧位通气可改善复杂先天性心脏病患儿的低氧血症,改善血气指标,是临床可行的支持治疗手段。Objective To investigate the effect of prone ventilation on hypoxemia after delayed chest closure in children with complex congenital heart disease.Methods Retrospective analysis of clinical data of 34 children with complicated congenital heart disease who underwent delayed chest closure in our hospital from January 2017 to December 2018.Prone position ventilation was performed for children with hypoxemia.Comparison of blood gas indicators[pressure of oxygen(PaO2),pressure of arterial carbon dioxide(PaCO2),arterial oxygen saturation(SaO2),lactic acid(Lac)]of children in the prone position before ventilation(T1),prone position 0.5 h(T2),prone position 1 h(T3),prone position 2 h(T4)Changes and changes in vital signs[heart rate(HR),ambulatory blood pressure(ABP),central venous pressure(CVP),respiratory rate(RR),pulse oxygen saturation(SpO2)].Results From T2 to T4,PaO2 and SaO2 were higher than T1,and PaCO2 and Lac were lower than T1,the difference was statistically significant(P<0.05).There was no significant difference in HR,ABP,CVP,RR at different time points(P>0.05);SpO2 at T2~T4 time points was higher than T1,the difference was statistically significant(P<0.05).Conclusion Prone ventilation can improve hypoxemia and improve blood gas index in children with complex congenital heart disease.It is a clinically feasible supportive treatment method.

关 键 词：俯卧位通气 先心病 延迟关胸 低氧血症 

分 类 号：R473.6[医药卫生—护理学]