CAJ | 학술논문

目的：比较重症ARDS患者在不同体位下进行肺复张治疗的效果以及对预后的影响。方法选择2011年3月-2013年3月入住我院重症医学科的重症ARDS患者120例，随机均分为俯卧位组和仰卧位组，两组患者均通过气管插管进行机械通气，其中俯卧位组在入组后立即进行俯卧位通气。两组患者均接受肺复张治疗，比较两组的一般情况、呼吸机设置、动脉血气分析及28d病死率。结果两组患者经过控制性肺膨胀法进行肺复张后均能提高患者的氧合指数，但俯卧位组改善更显著（P＜0.05）。俯卧位组的28d病死率及机械通气时间也显著降低（P＜0.001），但不良事件的发生率较仰卧位组高（P＜0.001）。结论俯卧位通气联合肺复张治疗能改善重症ARDS患者的氧合及预后。
목적：비교중증ARDS환자재불동체위하진행폐복장치료적효과이급대예후적영향。방법선택2011년3월-2013년3월입주아원중증의학과적중증ARDS환자120례，수궤균분위부와위조화앙와위조，량조환자균통과기관삽관진행궤계통기，기중부와위조재입조후립즉진행부와위통기。량조환자균접수폐복장치료，비교량조적일반정황、호흡궤설치、동맥혈기분석급28d병사솔。결과량조환자경과공제성폐팽창법진행폐복장후균능제고환자적양합지수，단부와위조개선경현저（P＜0.05）。부와위조적28d병사솔급궤계통기시간야현저강저（P＜0.001），단불량사건적발생솔교앙와위조고（P＜0.001）。결론부와위통기연합폐복장치료능개선중증ARDS환자적양합급예후。
Objective To compare the effects of recruitment maneuvers in different position on oxyenation and prognosis in patients with severe acute respirtory distress syndrome (ARDS). Methods 120 patients with severe ARDS during March 2011 to March 2013 were assigned to either prone or supine positioning groups. Both groups were undergo intubation ,Mechanical ventila-tion and recruitment maneuvers. To compare the characteristics,parameters of ventilation,arterial blood gas analysis and 28-day mortality. Results The oxyenation of patients in both groups were improved after recruitment maneuvers,but the prone group was better than supine group(P<0.05). The 28-day mortality was lower in prone group (P<0.001),but the adverse events were more of-ten in prone group (P<0.001). Conclusion Prone position ventilation combine with recruitment maneuvers can improve the oxye-nation and prognosis in patiens with severe ARDS.