CAJ | 학술논문

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1h氧合改善程度较仰卧位肺复张后1h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。
목적：평개앙와위、부와위폐복장대중증폐염환자혈류동역학、양합적영향。방법：장90례중증폐염환자수궤분위앙와위폐복장조、부와위폐복장조、앙와위폐복장＋부와위폐복장조。감측폐복장전、폐복장후5 min、복장후1 h혈류동역학화양합적변화。결과：량충체위하폐복장전화폐복장후5 min중심정맥압（CVP）、심장지수（CI）균강저，차이균유통계학의의（P＜0．05），단폐복장후1 h혈류동역학지표이접근폐복장전；량충체위폐복장전후양합지수（ PaO2/FiO2）균승고，차이균유통계학의의（ P＜0.05），차부와위폐복장후1h양합개선정도교앙와위폐복장후1h명현。결론：앙와위폐복장화부와위폐복장후적양합지수명현고우폐복장전，부와위비앙와위폐복장경능개선환자양합，폐복장대혈류동역학영향불명현。
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 PaO 2/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 .