现代中西医结合杂志
現代中西醫結閤雜誌
현대중서의결합잡지
MODERN JOURNAL OF INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE
2015年
11期
1158-1160,1164
,共4页
急性呼吸窘迫综合征%侧卧位通气%机械通气%氧合
急性呼吸窘迫綜閤徵%側臥位通氣%機械通氣%氧閤
급성호흡군박종합정%측와위통기%궤계통기%양합
acute respiratory distress syndrome%lateral ventilation%mechanical ventilation%oxygenation%complication
目的：研究侧卧位通气（ LPV）对不同程度急性呼吸窘迫综合征（ ARDS）患者的影响。方法根据入ICU第1天 p（ O2）／FiO2，将62例ARDS患者分为轻度组23例、中度组19例和重度组20例，3组均行LPV 1 h后恢复仰卧位通气。观察3组LPV前后血气分析指标p（O2）、p（CO2）、pH、p（O2）／FiO2，记录LPV前及LPV后20，406，0 min时的心率（HR）、平均动脉压（ MBP），并观察LPV相关不良事件发生情况。结果轻度组LPV前后p（ O 2）、p （ O 2）／FiO 2比较差异无统计学意义，中度组和重度组LPV后p（ O2）、p（ O2）／FiO2显著升高（ P＜0．05或P＜0．01）。3组LPV前后p（CO2）及pH值比较差异均无统计学意义。3组LPV后20，40，60 min时的HR和MBP与LPV前比较差异均无统计学意义。轻度组有3例出现受压皮肤发红，中度组及重度组各有1例，3组比较差异无统计学意义。结论 LPV能提高中、重度ARDS患者的p（ O 2）及p（ O 2）／FiO 2，对轻度ARDS患者的p（ O 2）及p（ O 2）／FiO 2没有明显影响，值得临床重视和运用。
目的：研究側臥位通氣（ LPV）對不同程度急性呼吸窘迫綜閤徵（ ARDS）患者的影響。方法根據入ICU第1天 p（ O2）／FiO2，將62例ARDS患者分為輕度組23例、中度組19例和重度組20例，3組均行LPV 1 h後恢複仰臥位通氣。觀察3組LPV前後血氣分析指標p（O2）、p（CO2）、pH、p（O2）／FiO2，記錄LPV前及LPV後20，406，0 min時的心率（HR）、平均動脈壓（ MBP），併觀察LPV相關不良事件髮生情況。結果輕度組LPV前後p（ O 2）、p （ O 2）／FiO 2比較差異無統計學意義，中度組和重度組LPV後p（ O2）、p（ O2）／FiO2顯著升高（ P＜0．05或P＜0．01）。3組LPV前後p（CO2）及pH值比較差異均無統計學意義。3組LPV後20，40，60 min時的HR和MBP與LPV前比較差異均無統計學意義。輕度組有3例齣現受壓皮膚髮紅，中度組及重度組各有1例，3組比較差異無統計學意義。結論 LPV能提高中、重度ARDS患者的p（ O 2）及p（ O 2）／FiO 2，對輕度ARDS患者的p（ O 2）及p（ O 2）／FiO 2沒有明顯影響，值得臨床重視和運用。
목적：연구측와위통기（ LPV）대불동정도급성호흡군박종합정（ ARDS）환자적영향。방법근거입ICU제1천 p（ O2）／FiO2，장62례ARDS환자분위경도조23례、중도조19례화중도조20례，3조균행LPV 1 h후회복앙와위통기。관찰3조LPV전후혈기분석지표p（O2）、p（CO2）、pH、p（O2）／FiO2，기록LPV전급LPV후20，406，0 min시적심솔（HR）、평균동맥압（ MBP），병관찰LPV상관불량사건발생정황。결과경도조LPV전후p（ O 2）、p （ O 2）／FiO 2비교차이무통계학의의，중도조화중도조LPV후p（ O2）、p（ O2）／FiO2현저승고（ P＜0．05혹P＜0．01）。3조LPV전후p（CO2）급pH치비교차이균무통계학의의。3조LPV후20，40，60 min시적HR화MBP여LPV전비교차이균무통계학의의。경도조유3례출현수압피부발홍，중도조급중도조각유1례，3조비교차이무통계학의의。결론 LPV능제고중、중도ARDS환자적p（ O 2）급p（ O 2）／FiO 2，대경도ARDS환자적p（ O 2）급p（ O 2）／FiO 2몰유명현영향，치득림상중시화운용。
Objective It is to investigate the efficacy of lateral position ventilation ( LPV) on the different severity of acute respiratory distress syndrome ( ARDS) .Methods 62 patients with ARDS in the general intensive care unit were divided into mild ARDS group (n=23), moderate ARDS group (n=19) and severe ARDS group(n=20), based on degree of hypoxemia p(O2)/FiO2 in the first day in ICU.All the patients were received LPV for 1 hour.The indexes of blood gas analysis such as p( O2 ) , p( CO2 ) , pH, p ( O2 )/FiO2 were compared before and after LPV in the three groups individually.The heart rate ( HR) and mean arterial pressure( MAP) was measured before LPV and every 20 minutes after LPV.The adverse events in the three groups were recorded.Results There was no significant difference in p( O 2) , p( O 2)/FiO 2 before and after LPV in mild ARDS group.The p( O 2) , p( O 2)/FiO 2 after LPV in moderate ARDS group and severe ARDS group was higher than before (P<0.05 or P<0.01).The pH and p(CO2) before and after LPV in the three groups had no significant difference.The HR and MAP in each time point after LPV had no difference compared with that before LPV in the three groups.There were 3 complications of decuhitus in mild ARDS group compared with 1 in moderate ARDS group and 1 in severe ARDS group.There was no statistically significant difference between the three groups.Conclusion LPV can be widespread used as a routine meth-od to therapy ARDS in moderate and severe ARDS which can increase p( O2 ) , p( O2 )/FiO2 of the patients.However, we also found that LPV could not increase the p( O 2) , p( O 2)/FiO 2 in mild ARDS.
