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目的探析俯卧位与仰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影响。方法选择本院2012年6月—2014年6月收治95例ARDS患者,随机分为A组(n=48)与B组(n=47),A组采取俯卧位通气,B组采取仰卧位通气,比较两组氧合指数、心率、平均动脉压、中心动脉压等血流动力学指标及痰液引流量。结果 A组通气2、24h时的PaO_2/FiO_2均大于B组,二组比较差异有统计学意义(P<0.05)。两组通气开始、通气2、24h的MAP与CVP的比较均无统计学意义;A组通气24h时HR高于B组,差异有统计学意义(P<0.05)。A组通气24h、24h时痰液引流量均高于B组,二组比较差异有统计学意义(P<0.05)。结论俯卧位通气利于提高ARDS患者氧合指数并促进引流,对血流动力学影响轻微,为ARDS理想辅助治疗方法。
Objective To investigate the effects of prone position and supine ventilation on the oxygenation, hemodynamics and sputum drainage in patients with acute respiratory distress syndrome (ARDS). Methods Ninety-five ARDS patients admitted to our hospital from June 2012 to June 2014 were randomly divided into group A (n = 48) and group B (n = 47). Group A received prone position ventilation and group B received supine position Ventilation, oxygenation index, heart rate, mean arterial pressure, central arterial pressure and other hemodynamic parameters and sputum drainage were compared. Results The PaO_2 / FiO_2 in group A at 2 and 24 hours after ventilation was higher than that in group B, the difference was statistically significant (P <0.05). There was no significant difference in MAP and CVP between the two groups at the beginning of ventilation and at 2,24 hours after ventilation. The HR at 24 hours after ventilation in group A was significantly higher than that in group B (P <0.05). A group of ventilation 24h, 24h sputum drainage were higher than the B group, the difference between the two groups was statistically significant (P <0.05). Conclusions Prone ventilation is beneficial to improve oxygenation index and promote drainage in patients with ARDS. It has a slight effect on hemodynamics and is an ideal adjuvant therapy for ARDS.