研究俯卧位通气治疗对急性百草枯中毒合并重度呼吸窘迫综合征氧合功能及预后的影响  

Effect of prone position ventilation on the oxygenation function and prognosis in patients with acute paraquat poisoning combined with severe respiratory distress syndrome

作　　者：周瑞雪 Zhou Ruixue(Jiaozuo Second People's Hospital,Jiaoziio,454000,Henan)

机构地区：[1]焦作市第二人民医院,河南焦作454000

出　　处：《辽宁医学杂志》2021年第5期30-32,共3页Medical Journal of Liaoning

摘　　要：目的研究俯卧位通气治疗对急性百草枯中毒合并重度呼吸窘迫综合征(ARDS)氧合功能及预后的影响。方法选取2016年1月至2019年12月我院急诊科收治的62例急性百草枯中毒合并重度ARDS的患者,将患者分为俯卧组(行俯卧位通气)32例和对照组(未行俯卧位通气)30例。分析两组患者住院前7天的氧合指数,同时比较两组患者住院1个月的病死率、住院时间、机械通气时间及不良事件发生率。结果在基线一致的前提下,两组患者的动脉血氧分压(PaO2)在入组后第1、3、5、7d无统计学差异(P>0.05);俯卧组患者的氧合指数(PaO2/FiO2)在第5、7d显著高于对照组,差异具有统计学意义(P<0.05);俯卧组患者1个月的病死率15.62%(5/32)低于对照组33.33%(10/30),不良事件发生率俯卧组18.75%(6/32)低于对照组43.33%(13/30),差异具有统计学意义(P<0.05);两组患者总的入住重症加强护理病房(ICU)时间差异无统计学意义(P>0.05),但在存活病人中,俯卧组患者入住ICU时间短于对照组,且机械通气时间也短于对照组,差异具有统计学意义(P<0.05)。结论俯卧位通气治疗可改善急性百草枯中毒合并ARDS患者的氧合功能及患者住病死率、住院时间、机械通气时间、不良事件发生率等各项指标。Objective To study the effect of prone position ventilation on the oxygenation function and prognosis in patients with acute paraquat poisoning combined with acute respiratory distress syndrome(ARDS).Methods Sixty-two patients with acute paraquat poisoning combined with severe ARD admitted to the emergency department of our hospital from January 2016 to December 2019 were enrolled and divided into prone group(prone ventilation, n=32)and control group(no prone ventilation, n=30).The oxygenation index of the two groups of patients before 7 days of hospitalization was analyzed, and the mortality, hospitalization time, mechanical ventilation time, and incidence of adverse events of the two groups of patients during 1 month of hospitalization were compared.Results Under the premise of consistent baseline, The arterial oxygen partial pressure(PaO2)of the two groups of patients was not significantly different on the 1 st, 3 rd, 5 th, and 7 th days after enrollment(P>0.05).The oxygenation index(PaO2/FiO2)of the prone group was significantly higher than that of the control group at 5 th and 7 th days(P<0.05).The one-month mortality rate of patients in the prone group was lower than that in the control group[15.62%(5/32)vs.33.33%(10/30)].The incidence of adverse events in the prone group was lower than that in the control group[18.75%(6/32)vs.43.33%(13/30),P<0.05].The total time in the intensive care unit(ICU)of the two groups was not statistical significant(P>0.05),but among the surviving patients, the time of the prone group was shorter than the control group, and the mechanical ventilation time was shorter than the control group(P<0.05).Conclusion Prone position ventilation therapy can improve the oxygenation function, patient mortality, hospitalization time, mechanical ventilation time, adverse event rate and other indicators in patients with acute paraquat poisoning and ARDS.

关 键 词：俯卧位通气 急性百草枯中毒 重度呼吸窘迫综合征 氧合功能 

分 类 号：R563.8[医药卫生—呼吸系统] R595.4[医药卫生—内科学]