APRV模式联合俯卧位通气在中重度急性呼吸窘迫综合征患者中的应用效果  

Application Effect of APRV Mode Combined with Prone Ventilation in Patients with Moderate to Severe Acute Respiratory Distress Syndrome

作　　者：曹培雨 张晴晴 CAO Peiyu;ZHANG Qingqing(Xuzhou Cancer Hospital,Xuzhou 221005,China;不详)

机构地区：[1]徐州市肿瘤医院,江苏徐州221005 [2]徐州市新健康老年病医院

出　　处：《中外医学研究》2024年第34期18-21,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨气道压力释放通气(APRV)模式联合俯卧位通气在中重度急性呼吸窘迫综合征(ARDS)患者中的应用效果。方法:按照随机数表法将2022年6月—2023年5月徐州市肿瘤医院与徐州市新健康老年病医院收治的91例中重度ARDS患者分为对照组(n=45,俯卧位通气)和观察组(n=46,在对照组基础上联合APRV模式)。评估对比两组患者的动脉血气指标、呼吸功能及临床预后情况。结果:观察组治疗1 h、24 h、48 h动脉血氧饱和度(SaO_(2))、肺动态顺应性(Cydn)、动脉血氧分压(PaO_(2))及氧合指数(PaO_(2)/FiO_(2))水平高于对照组,气道平均压(Pmean)、动脉二氧化碳分压(PaCO_(2))、气道峰压(Ppeak)低于对照组,机械通气时间及重症监护病房(ICU)住院时间短于对照组,差异有统计学意义(P<0.05);观察组28 d病死率低于对照组(10.87%vs 28.89%),差异有统计学意义(P<0.05)。结论:APRV模式联合俯卧位通气可显著改善中重度ARDS患者动脉血气指标、呼吸功能、氧合功能及肺顺应性,缩短患者通气时间及住院时间,促进患者良好预后。Objective:To explore the application effect of airway pressure release ventilation(APRV)mode combined with prone ventilation in patients with moderate to severe acute respiratory distress syndrome(ARDS).Method:According to the random number table method,91 patients with moderate to severe ARDS admitted to Xuzhou Cancer Hospital and Xuzhou New Healthy Hospital from June 2022 to May 2023 were divided into the control group(n=45,prone ventilation)and the observation group(n=46,combined with APRV mode on the basis of the control group).The arterial blood gas index,respiratory function and clinical prognosis of the two groups were assessed and compared.Result:The levels of arterial oxygen saturation(SaO_(2)),pulmonary dynamic compliance(Cydn),arterial partial pressure of oxygen(PaO_(2))and oxygenation index(PaO_(2)/FiO_(2))in the observation group were higher than in the control group at 1 h,24 h and 48 h of treatment,and the levels of mean airway pressure(Pmean),arterial partial pressure of carbon dioxide(PaCO_(2)),peak airway pressure(Ppeak)in the observation group were lower than in the control group,duration of mechanical ventilation and intensive(ICU)were shorter than those of the control group,and the differences were statistically significant(P<0.05).The 28 d morbidity and mortality rate of the observation group was lower than that of the control group(10.87%vs.28.89%),and the difference was statistically significant(P<0.05).Conclusion:APRV mode combined with prone ventilation can significantly improve arterial blood gas indexes,respiratory function,oxygenation function and lung compliance in patients with moderate to severe ARDS,shorten ventilation time and hospital stay,and promote good prognosis.

关 键 词：气道压力释放通气 俯卧位通气 急性呼吸窘迫综合征 肺顺应性 

分 类 号：R563.8[医药卫生—呼吸系统]