| 高文蔚,赵 博,邱 珍,刘 恋,汪华新.不同俯卧位通气时间对中重度肺内/外源性ARDS患者的治疗效果[J].,2017,17(24):4657-4659 |
| 不同俯卧位通气时间对中重度肺内/外源性ARDS患者的治疗效果 |
| Clinical Effect of Different Ventilation Time at Prone Position on the Patients with Endogenous/Exogenous ARDS |
| 投稿时间：2016-10-16 修订日期：2016-11-10 |
| DOI：10.13241/j.cnki.pmb.2017.24.013 |
| 中文关键词: 急性呼吸窘迫综合征 俯卧位通气 氧合指数 |
| 英文关键词: Acute respiratory distress syndrome Prone position ventilation Oxygenation |
| 基金项目:湖北省自然科学基金项目(2016CFB167)；中央高校基本科研业务费专项基金(2042017kf0147) |
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| 中文摘要: |
| 摘要 目的：探讨中重度肺内/外源性ARDS患者行不同时间俯卧位通气的治疗效果。方法：将中重度30例肺内/30例外源性ARDS患者分别行2h、4h俯卧位通气，观察患者APCHEII评分，氧合指数、胸片吸收情况、心率、平均动脉压、脱机拔管时间，出ICU时间。结果：四组患者APCHEII评分、心率、平均动脉压比较差异均无统计学意义(P>0.05)。肺内源性ARDS患者行2 h、4 h俯卧位通气均能有效改善患者氧合指数，4 h组较2 h组氧合指数改善、胸片吸收情况更明显，4 h组在脱机时间、转出ICU时间均优于2 h组(P<0.05)；肺外源性ARDS患者行2 h、4 h俯卧位通气均能有效改善患者各项指标，但两组间无统计学差异(P>0.05)，且均优于肺内源性ARDS患者(P<0.05)。结论：俯卧位通气可改善中重度肺内/外源性ARDS患者的病情，其对肺外源性ARDS患者效果更好，2 h俯卧位通气即能取得较好效果，而肺内源性ARDS患者需更长时间的俯卧位通气改善病情且预后较差。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of different ventilation time in the prone position on patients with endogenous/exogenous ARDS. Methods: 30 endogenous/ 30 exogenous ARDS patients were randomly devided into 4 groups, ventilation in the prone position for 2 h and 4 h. Recording the score of APCHEII, oxygenation index, the absorption situation in X-ray, HR, MAP, extubation time, the time out of ICU. Results: The APCHEII scores HR and MAP in four groups have no significant statistics (P>0.05); 4 h ventilation for endogenous ARDS patients has a better indicators than 2 h in oxygenation index, the absorption situation in X-ray, extubation time and the time out of ICU(P<0.05); 2 h and 4 h ventilation for exogenous ARDS patients can improve indicators above, two groups have no significant statistics (P>0.05), the results of exogenous groups are precede than endogenous group(P<0.05). Conclusion: Ventilation in the prone position can improve the situation of ARDS patients, both endogenous patients and exogenous patients. Exogenous ARDS patients have a better treatment effect after the ventilation of 2h, however, endogenous patients need longer time and have a non-ideal prognosis. |
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