俯卧位通气对爆震伤、烧伤并发ARDS治疗的影响

The value of prone position ventilation on treatment of the patients with explosive injury and burn combine with ARDS

目的通过观察仰卧位通气与俯卧位通气血流动力学指标和呼吸参数,探讨俯卧位通气在爆震伤、烧伤并发ARDS治疗中的价值。方法分别记录23例ARDS患者每次仰卧位(翻身前)及俯卧位(翻身后)5min、30min、60min时的血流动力学指标和呼吸参数。结果俯卧位通气对Hr、PIP、Raw、SaO2改善在俯卧位后5min、30min较明显,与仰卧位通气比较有显著性差异(P<0.05),但对CVP、Vt改变不明显(P>0.05)。结论俯卧位通气较仰卧位通气能明显改善ARDS患者的氧合,对血流动力学没有明显影响。

Objective To compare supine position and prone position ventilation in patients with acute respiratory distress syndrome（ARDS）.By the hemodynamic indices and breath parameter so as to expolore the value of prone position ventilation on treatment of the patients with explosive injury and burn combine with ARDS.Methods Hemodynamic indices and breath parameter in 23 patients with ARDS were recorded in the supine position and in the 5 min,30 min,60 min after the prone position ventilation.Results There were obvious ameliration to HR,PIP,Raw and SaO2 in the prone position ventilation at the 5 min and 30 min,compared with the supine position ventilation（P0.05）.There were no signficant differences in Vt and CVP（P0.05）.Conclusion The prone position ventilation can ameliorate oxygeration in ARDS patient compared with the supine position ventilation,but can＇t ameliorate hemodynamic indices obviously.