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目的探讨俯卧位通气联合肺复张对急性呼吸窘迫综合征(ARDS)的疗效。方法 ARDS患者42例随机均分为两组:对照组采用常规机械通气基础上运用压力控制法肺复张策略;试验组采用俯卧位机械通气基础上运用压力控制法肺复张策略。比较两组患者分组后1、2、6h肺复张后HR、CVP、MAP、PaO_2、氧合指数(OI)、气道平台压(Pplat)和静态肺顺应性(Clst)的变化。结果试验组PaO_2和OI较对照组改善更为明显(P<0.05);两组肺复张前后Pplat、Clst比较差异无统计学意义(P>0.05)。两组肺复张后HR、CVP、MAP比较差异亦无统计学意义(P>0.05)。结论俯卧位联合压力控制法肺复张能更有效改善ARDS患者的氧合状态,且对血流动力学影响小。
Objective To investigate the effect of prone position ventilation combined with pulmonary reexpansion on acute respiratory distress syndrome (ARDS). Methods Forty-two patients with ARDS were randomly divided into two groups: the control group was given conventional mechanical ventilation based on the method of pressure control and pulmonary reexpansion; the experimental group was based on the mechanical ventilation of prone position and the pressure control method was used for pulmonary reexpansion. The changes of HR, CVP, MAP, PaO 2, oxygenation index (OI), Pplat and Clst after 1, 2, 6 h lung resuscitation were compared between the two groups. Results The PaO_2 and OI of the experimental group improved more obviously than that of the control group (P <0.05). There was no significant difference in Pplat and Clst between the two groups before and after pulmonary recanalization (P> 0.05). There was no significant difference in HR, CVP and MAP between the two groups (P> 0.05). Conclusions Pulmonary reclaim combined with pressure control in prone position can effectively improve the oxygenation status of patients with ARDS and has little effect on hemodynamics.