仰卧位和俯卧位肺复张对重症肺炎患者治疗效果的比较-东南大学学报医学版

仰卧位和俯卧位肺复张对重症肺炎患者治疗效果的比较

单位：新疆医科大学第一附属医院,新疆乌鲁木齐 830011

分类号：R563.1

出版年·卷·期（页码）：2014·33·第二期（167-170）

摘要：

目的：评价仰卧位、俯卧位肺复张对重症肺炎患者血流动力学、氧合的影响。方法：将90例重症肺炎患者随机分为仰卧位肺复张组、俯卧位肺复张组、仰卧位肺复张+俯卧位肺复张组。监测肺复张前、肺复张后5 min、复张后1 h血流动力学和氧合的变化。结果：两种体位下肺复张前和肺复张后5 min中心静脉压（CVP）、心脏指数（CI）均降低，差异均有统计学意义（P<0.05），但肺复张后1 h血流动力学指标已接近肺复张前；两种体位肺复张前后氧合指数（PaO₂/FiO₂）均升高，差异均有统计学意义（P<0.05），且俯卧位肺复张后1 h氧合改善程度较仰卧位肺复张后1 h明显。结论：仰卧位肺复张和俯卧位肺复张后的氧合指数明显高于肺复张前，俯卧位比仰卧位肺复张更能改善患者氧合，肺复张对血流动力学影响不明显。

Objective: To explore the effects of prone and supine position ventilation combined with recruitment maneuver on patients with severe pneumonia. Methods: 90 cases were randomly divided into three groups, including prone position group, supine position group, prone position combined supine position group. Results: Compared with data before recruitment maneuver, CI and CVP were decreased significantly after recruitment maneuver 5 minutes in both supine position and prone position group(P<0.05), then they returned to the base level an hour later,but significant differences in PaO₂/FiO₂ were found between before and after recruitment maneuver when patients' position was changed, and it suggest that recruitment maneuver improved oxygenation more effectively in prone compared with supine position. Conclusions: Prone and supine position ventilation combined with recruitment maneuver significantly improves oxygenation in severe pneumonia patients,but slightly changes hemodynamics.

参考文献：

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