俯卧位通气加肺复张对急性呼吸窘迫综合征的作用.docVIP

俯卧位通气加肺复张对急性呼吸窘迫综合征的作用 　　doi：10.3969/j.issn.1007-614x.2014.15.24 　　摘 要 目的：探讨在临床上采取俯卧位通气（PP）加肺复张（RM）对急性呼吸窘迫综合征（ARDS）的治疗效果。方法：针对ARDS患者采取PP治疗加RM联合治疗2次，治疗间隔4小时。对于治疗效果不明显的患者采取24小时之后的再次PP治疗，持续6小时。并在治疗的前后各2小时节点联合RM治疗。记录患者在3次治疗前后的动脉血气和氧合指标。并采取统计学方法比较差异。结果：42例患者在治疗的过程中，未出现严重并发症。治疗后PaO2、 PaCO2、 PaO2/FiO2与治疗前相比，差异均有统计学意义（P0.05）。3次治疗后患者PaO2均得到显著性提高，且差异具有统计学意义（P0.05）。从第2次治疗之后，PaCO2的下降趋势并不明显。PaO2/FiO2为第1次和第2次治疗前后的差距最大，和其他几次治疗的区间差异具有统计学差异（P0.05）。结论：采取PP联合RM治疗ARDS，可缓解患者的低氧和缺氧症状，有利于患者的康复和高碳酸血症的纠正，值得大力推广。 　　关键词 俯卧位通气 肺复张 急性呼吸窘迫综合征 　　The effect of prone position ventilation and recruitment manoeuvre on acute respiratory distress syndrome 　　Zhan Xiumei 　　Department of Respiration，the Peoples Hospital of Pizhou City，Jiangsu 221300 　　Abstract Objective：To explore the treatment effect of prone position ventilation and recruitment manoeuvre on acute respiratory distress syndrome in the clinical.Methods：Patients with acute respiratory distress syndrome（ARDS） treated with two combined treatment of prone position ventilation（PP） and recruitment manoeuvre（RM）.The treatment interval was 4 hours.The patients whose treatment effect was not obvious were given PP treatment again after 24 hours.The treatment was continued for 6 hours.Before and after treatment，all patients were combined with RM treatment each 2 hours.After 3 times of treatment，the arterial blood gases and oxygenation index of patients before and after the treatment were recorded.The difference was compared by statistical method.Results： There was no severe complications.After treatment， the differences of PaO2， PaCO2， and PaiO2/ FiO2 compared with before treatment were statistically significant （P0.05）.After the third treatment， PaO2 was significantly improved， and the difference was statistically significant（P0.05）.After the second treatment， PaCO2 downward trend was not obvious. The differences of PaO2 / FiO2 for first and second treatment and other several treatment were statistically significant（P0.05）.Conclusion： PP