俯卧位机械通气在AECOPD患者中的应用效果  

Application effect of prone position mechanical ventilation in patients with AECOPD

作　　者：黄燕萍 郦文泽[1] HUANG Yanping;LI Wenze(Intensive Care Unit,Zhejiang Litongde Hospital,Hangzhou 311122,China)

机构地区：[1]浙江省立同德医院ICU,浙江杭州311122

出　　处：《中国现代医生》2021年第23期13-16,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2019ZB025)。

摘　　要：目的探讨俯卧位机械通气在慢性阻塞性肺病急性加重期患者中的应用。方法选择2019年1月至2020年4月在我院治疗的COPD急性加重期患者100例为研究对象,随机分为观察组与对照组各50例。所有患者均给予常规治疗以及机械通气,观察组行俯卧位机械通气,对照行仰卧位机械通气。比较治疗前后动脉血气分析、血氧饱和度、肺动脉顺应性;氧合指数、APACHEⅡ等指标。结果(1)治疗后,两组PaO_(2)、pH、BE较治疗前显著提高,差异有统计学意义(P<0.05);PaCO_(2)较治疗前显著下降(P<0.05);治疗后,观察组PaO_(2)、pH、BE显著高于对照组,PaCO_(2)显著低于对照组,(P<0.05)。(2)治疗后,两组肺动态顺应性、SaO_(2)、PaO_(2)/FiO_(2)均有所改善,显著高于治疗前(P<0.05);治疗后,观察组肺动态顺应性、SaO_(2)、PaO_(2)/FiO_(2)显著高于对照组(P<0.05)。(3)治疗后两组APACHEⅡ评分均较治疗前显著下降(P<0.05);治疗后,观察组APACHEⅡ评分显著低于对照组(P<0.05)。结论俯卧位机械通气治疗AECOPD可显著改善动脉血气分析结果、肺动态顺应性、SaO_(2)、PaO_(2)/FiO_(2)、APACHEⅡ等指标。Objective To explore the application of prone position mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods A total of 100 patients with acute exacerbation of COPD treated in our hospital from January 2019 to April 2020 were selected as the research objects.They were randomly divided into the observation group and the control group with 50 cases in each group.All patients were given conventional treatment and mechanical ventilation.The control was given mechanical ventilation in the supine position,and the observation group was given mechanical ventilation in the prone position.The arterial blood gas analysis,blood oxygen saturation,pulmonary artery compliance,oxygenation index,and APACHEⅡbefore and after treatment were compared.Results(1)The PaO_(2),pH,and BE of the two groups after treatment were significantly higher than those before treatment,and the difference was statistically significant(P<0.05).The PaO_(2),pH,and BE of the observation group were significantly higher than those of the control group after treatment.The PaCO_(2) of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).(2)The pulmonary dynamic compliance,SaO_(2),PaO_(2)/FiO_(2) of the two groups after treatment was improved,which was significantly higher than that before treatment(P<0.05).The observation group's pulmonary dynamic compliance,SaO_(2),PaO_(2)/FiO_(2) were significantly higher than those in the control group after treatment(P<0.05).(3)The APACHEⅡscores of the two groups after treatment were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).The APACHEⅡscore of the observation group after treatment was significantly lower than that of the control group(P<0.05).Conclusion The prone position mechanical ventilation can significantly improve the results of arterial blood gas analysis,pulmonary dynamic compliance,SaO_(2),PaO_(2)/FiO_(2),and APA

关 键 词：俯卧位机械通气 慢性阻塞性肺病 急性加重期 氧合指数 肺动态顺应性 

分 类 号：R725.6[医药卫生—儿科]