摘要
目的探讨侧卧位通气对急性呼吸窘迫综合征(ARDS)患者氧合、血流动力学及痰液引流的影响。方法纳入25例ARDS患者,监测初始仰卧位、侧卧位1小时后、转仰卧位1小时各时间点的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、动脉血氧分压(PaO2)、氧合指数(PaO2/FiO2)、痰液引流量等指标。结果与初始仰卧位比较,患者侧卧位1小时PaO2(75±12)mmHg vs(65±11)mmHg,PaO2/FiO2(280±14)mmHg vs(200±20)mmHg明显升高(P<0.05),SpO2(96.5±2.2)vs(88.5±1.2)明显升高(P<0.05),且转仰卧位1小时仍能保持,MAP、HR差异无统计学意义(P>0.05),侧卧位1小时气道痰液引流量较初始仰卧位明显增加(15.2±1.8)ml vs(8.2±2.0)ml(P<0.05)。结论侧卧位通气可改善ARDS患者的氧合,且恢复仰卧位后氧合改善持续存在;可改善气道痰液引流,但对血流动力学、呼吸机力学参数无明显影响。
ABSTRACT：Objective To investigate the effects of lateral position ventilation on oxygenation,hemodynamics and airway drainage in patients with acute respiratory distress syndrome（ARDS）.Methods Twenty-five patients with ARDS were recruited in the study.Mean blood pressure（MAP）,heart rate（HR）,pulse oxygen saturation（SpO2 ）, arterial oxygen tension（PaO2 ）,oxygenation index（PaO2/FiO2 ）and sputum drainage were recorded in the time points of initial supine position,lateral position 1 h,and return to supine position 1 h.Results Compared with the time point of initial supine position,PaO2 and PaO2/FiO2 increased significantly after 1 h in prone position,PaO2 ：（75 ± 12） mmHg vs （65 ± 11）mmHg;PaO2/FiO2 ：（280 ± 14）mmHg vs （200 ± 20）mmHg（all P 〈0.05）.The effects of oxygenation improvement were persistent for 1 h after returned to supine position.There was no significant difference in MAP,HR during the study.Airway sputum drainage was significantly increased 1 h after lateral position compared with that initial supine position（15.2±1.8）ml vs （8.2±2.0）ml（P 〈0.05）.Conclusion Lateral position ventilation can improve the oxygenation in patients with ARDS,and the effects of oxygenation improvement can be persistent after returned to supine position.Lateral position ventilation can improve sputum drainage without significant influence on hemodynamics and respiratory mechanics parameters.
出处
《临床荟萃》
CAS
2015年第1期51-53,共3页
Clinical Focus
关键词
呼吸窘迫综合征
成人
通气机
机械
体位
血流动力学
气道引流
respiratory distress syndrome,adult
ventilators,mechanical
posture
hemodynamics
airway drainage
