俯卧位通气对心外科手术后低氧血症患者的影响研究  

Study on the effect of prone position ventilation on patients with hypoxemia after cardiac surgery

作　　者：刘丽[1] 邢丽娜 王沅芷 马晶[1] Liu Li;Xing Lina;Wang Yuanzhi;Ma Jing(The Second Department of Critical Care Medicine,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院重症医学二科,乌鲁木齐830000

出　　处：《中国体外循环杂志》2025年第2期127-131,139,共6页Chinese Journal of Extracorporeal Circulation

基　　金：自治区科技支疆项目计划(2022E02112)。

摘　　要：目的评估俯卧位通气治疗对心脏外科术后低氧血症患者的临床效果和康复影响。方法前瞻性纳入120例心脏外科术后低氧血症患者,采用随机数表法将患者分为俯卧位通气组和对照组。俯卧位通气组患者于ICU内接受俯卧位通气治疗,对照组进行常规治疗。分别于治疗前及治疗后24 h、48 h、72 h监测生命体征并进行血气分析。比较两组患者的动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))、动脉氧饱和度(SaO_(2))或脉搏氧饱和度(SpO_(2))、生命体征和术后并发症等指标。结果与对照组相比,治疗前PaO_(2)、PaCO_(2)、PaO_(2)/FiO_(2)和SaO_(2)数值和入组后24 h、48 h、72h的生命体征(体温、心率、呼吸频率、收缩压和舒张压)均无显著差异(P>0.05);俯卧位通气组患者在入组后24h、48h、72h的PaO_(2)、PaCO_(2)、PaO_(2)/FiO_(2)和SaO_(2)均显著优于对照组(P<0.05)且术后并发症发生率、脱机时间显著降低(P<0.05)。结论俯卧位通气治疗能够显著改善心脏外科术后低氧血症患者的氧合状态,减少二氧化碳潴留,降低术后并发症发生率,为其康复提供积极作用。Objective The study aimed to evaluate the clinical efficacy and rehabilitation impact of prone position ventilation therapy on patients with hypoxemia after cardiac surgery.Methods A total of 120 patients with postoperative hypoxemia after cardiac surgery were prospectively included and randomly divided into a prone position ventilation group and a control group using a random number table method.Patients in the prone position ventilation group received prone position ventilation treatment in the ICU,while the control group received routine treatment.Vital signs and blood gas analysis results before treatment and at 24,48,and 72 hours after treatment were recorded.Arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(PaO_(2)/FiO_(2)),oxygen saturation(SaO_(2)/SPO_(2)),vital signs and postoperative complications were compared between the two groups.Results Compared with the control group,the values of PaO_(2),PaCO_(2),PaO_(2)/FiO_(2) and SaO_(2) before treatment and the vital signs(body temperature,heart rate,respiratory rate,systolic and diastolic blood pressure)at 24 h,48 h and 72 h after treatment were not significantly different(P>0.05).The PaO_(2),PaCO_(2),PaO_(2)/FiO_(2) and SaO_(2) in prone ventilation group at 24 h,48 h and 72 h after admission were significantly better than those in control group(P<0.05),and the incidence of postoperative complications and offline time were significantly decreased(P<0.05).Conclusion Prone ventilation significantly improves oxygenation status,reduces carbon dioxide retention,and decreases postoperative complications in patients with low oxygen saturation after cardiac surgery,providing a positive impact on their recovery.

关 键 词：俯卧位通气治疗 心脏外科术后 低血氧饱和度 氧合指数 

分 类 号：R654.1[医药卫生—外科学]