摘要
目的:观察俯卧位机械通气治疗急性呼吸窘迫综合征(ARDS)患者的效果。方法:选取2020年1月至2023年11月该院收治的80例ARDS患者进行前瞻性研究,按照随机信封法将其分为对照组与观察组各40例。对照组采用保护性机械通气治疗,观察组采用俯卧位机械通气治疗。比较两组临床疗效,治疗前后通气功能指标[第1秒用力呼气容积(FEV_(1))、呼气峰值流速(PFE)]、血流动力学指标(心率、平均动脉压、中心静脉压)、血气分析指标[动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SpO2)、动脉血氧分压(PaO_(2))]水平,以及并发症发生率。结果:观察组治疗总有效率为95.00%(38/40),高于对照组的80.00%(32/40),差异有统计学意义(P<0.05);治疗后,两组PFE、FEV_(1)水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组心率、中心静脉压水平均低于治疗前,且观察组低于对照组,两组平均动脉压水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组PaCO_(2)水平均低于治疗前,且观察组低于对照组,两组PaO_(2)、SpO2水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.00%(2/40),低于对照组的22.50%(9/40),差异有统计学意义(P<0.05)。结论:俯卧位机械通气治疗ARDS患者可提高治疗总有效率和通气功能指标水平,改善血流动力学指标和血气分析指标水平,以及降低并发症发生率,效果优于保护性机械通气治疗。
Objective:To observe effect of prone position mechanical ventilation on patients with acute respiratory distress syndrome(ARDS).Methods:A prospective study was conducted on 80 patients with ARDS admitted to the hospital from January 2020 to November 2023.According to the random envelope method,they were divided into control group and observation group,40 cases in each group.The control group was treated with protective mechanical ventilation,while the observation group adopts prone position mechanical ventilation.The clinical efficacy,the levels of ventilation function indexes[forced expiratory volume in one second(FEV_(1)),peak expiratory flow(PFE)],hemodynamic indexes(heart rate,mean arterial pressure,central venous pressure)and blood gas analysis indexes[arterial partial pressure of carbon dioxide(PaCO_(2)),arterial oxygen saturation(SpO2),arterial partial pressure of oxygen(PaO_(2))]before and after the treatment,and the incidence of complications were compared between the two groups.Results:The total effective rate of the observation group was 95.00%(38/40),which was higher than 80.00%(32/40)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of PFE and FEV_(1) in the two groups were higher than those before the treatment,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the heart rate and central venous pressure of the two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;the mean arterial pressure levels of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;and the differences were statistically significant(P<0.05).After the treatment,the PaCO_(2)levels of the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;the levels of PaO_(2) and SpO2 in the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 5.00%(2/40),which was lower than 22.50%(9/40)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Prone position mechanical ventilation in the treatment of the ARDS patients can improve the total effective rate of treatment and the levels of ventilation function indexes,improve the levels of hemodynamic indexes and blood gas analysis indexes,and reduce the incidence of complications.Moreover,it is superior to simple protective mechanical ventilation.
作者
齐艳坡
闫圣杰
陈俊
廖煜
QI Yanpo;YAN Shengjie;CHEN Jun;LIAO Yu(Department of Critical Care Medicine of Zhengzhou No.1 People’s Hospital,Zhengzhou 450000 Henan,China)
出处
《中国民康医学》
2025年第20期42-45,共4页
Medical Journal of Chinese People’s Health
关键词
俯卧位机械通气
保护性机械通气:急性呼吸窘迫综合征
通气功能
血流动力学
血气分析
并发症
Prone position mechanical ventilation
Protective mechanical ventilation
Acute respiratory distress syndrome
Ventilation function
Hemodynamics
Blood gas analysis
Complication
