中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
15期
41-41,43
,共2页
俯卧位通气%肺复张%急性呼吸窘迫综合征
俯臥位通氣%肺複張%急性呼吸窘迫綜閤徵
부와위통기%폐복장%급성호흡군박종합정
Prone position ventilation%Recruitment manoeuvre%Acute respiratory distress syndrome
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(P＜0.05)。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(P＜0.05)。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(P＜0.05)。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。
目的：探討在臨床上採取俯臥位通氣(PP)加肺複張(RM)對急性呼吸窘迫綜閤徵(ARDS)的治療效果。方法：針對ARDS患者採取PP治療加RM聯閤治療2次，治療間隔4小時。對于治療效果不明顯的患者採取24小時之後的再次PP治療，持續6小時。併在治療的前後各2小時節點聯閤RM治療。記錄患者在3次治療前後的動脈血氣和氧閤指標。併採取統計學方法比較差異。結果：42例患者在治療的過程中，未齣現嚴重併髮癥。治療後 PaO2、 PaCO2、PaO2/FiO2與治療前相比，差異均有統計學意義(P＜0.05)。3次治療後患者PaO2均得到顯著性提高，且差異具有統計學意義(P＜0.05)。從第2次治療之後，PaCO2的下降趨勢併不明顯。PaO2/FiO2為第1次和第2次治療前後的差距最大，和其他幾次治療的區間差異具有統計學差異(P＜0.05)。結論：採取PP聯閤RM治療ARDS，可緩解患者的低氧和缺氧癥狀，有利于患者的康複和高碳痠血癥的糾正，值得大力推廣。
목적：탐토재림상상채취부와위통기(PP)가폐복장(RM)대급성호흡군박종합정(ARDS)적치료효과。방법：침대ARDS환자채취PP치료가RM연합치료2차，치료간격4소시。대우치료효과불명현적환자채취24소시지후적재차PP치료，지속6소시。병재치료적전후각2소시절점연합RM치료。기록환자재3차치료전후적동맥혈기화양합지표。병채취통계학방법비교차이。결과：42례환자재치료적과정중，미출현엄중병발증。치료후 PaO2、 PaCO2、PaO2/FiO2여치료전상비，차이균유통계학의의(P＜0.05)。3차치료후환자PaO2균득도현저성제고，차차이구유통계학의의(P＜0.05)。종제2차치료지후，PaCO2적하강추세병불명현。PaO2/FiO2위제1차화제2차치료전후적차거최대，화기타궤차치료적구간차이구유통계학차이(P＜0.05)。결론：채취PP연합RM치료ARDS，가완해환자적저양화결양증상，유리우환자적강복화고탄산혈증적규정，치득대력추엄。
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 (P<0.05).After the third treatment, PaO2 was significantly improved, and the difference was statistically significant(P<0.05).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(P<0.05). Conclusion: PP combined with RM in the treatment of ARDS can be beneficial to alleviate the hypoxia and anoxia symptom of the patients.It is conducive to the rehabilitation of patients and rectify the hypercapnia.So it is worth to popularize.
