俯卧位通气垫在急性呼吸窘迫综合征患者俯卧位机械通气中的应用效果观察

Result Observation of Prone Position Air Cushion Application in Prone Position Mechanical Ventilation of Acute Respiratory Distress Syndrone Patients

目的 评估俯卧位通气垫在急性呼吸窘迫综合征（ARDS）患者俯卧位机械通气中的应用效果。方法 选取2014-01～2015-02间在黑龙江省医院诊断为ARDS的32例患者,按照随机数字表法将其分为俯卧位通气垫组和传统翻身床组,每组各16例。在内科常规用药的基础上,分别采取7 d间断的俯卧位通气垫方式机械通气和传统的翻身床方式机械通气。治疗前后用血气分析、呼吸机参数指标评估两组患者的疗效。结果 俯卧位通气垫组患者俯卧位通气3 h后肺重力依赖区的肺通气评分较俯卧位即刻评分明显下降,氧和指数明显升高,差异有统计学意义（P〈0.05）。俯卧位通气垫组并发症明显少于传统翻身床组,差异有统计学意义（P〈0.05）。结论 俯卧位通气垫和传统翻身床在急性呼吸窘迫综合征患者机械通气治疗中均具有一定效果,俯卧位通气垫因较少的并发症,可使患者早期脱机,降低病死率,降低医疗费用,更具有临床推广价值。

Objective To evaluate curative effect of prone position on air cushion in the prone position ventilation in patients with acute respiratory distress syndrome. Methods Selecting 32 ARDS patients from January, 2014 to February, 2014 in Heilongjiang Provincial Hospital, and according to random number table method, they were randomly divided into prone position air cushion treatment group and the traditional emancipated bed treatment group, with 16 patients in each group. On the basis of conventional drugs, they were given seven days of prone position air cushion of mechanical ventilation and emancipated bed of traditional mechanical ventilation. Blood gas analysis and re- spiratory machine parameters before and after treatment were used to evaluate the efficacy of two groups. Results Prone position mechanical ventilation 3h later, breathing machine parameters of the change of gravity dependent lung ventilation significantly reduced, and oxygenation index significantly enhanced（ P 〈 0. 05 ）. Complications in prone position air cushion group were obviously less than traditional emancipated bed group, and difference was statistically significant （ P 〈 0.05 ）. Conclusion Air cushion and traditional emancipated bed mechanical ventilation in the treatment of adult acute respiratory distress syndrome all have certain curative effect. Prone position air cushion because of fewer complications makes early weaning patients, reduces the ease fatality rate, and reduces medical costs. So it is worth clinical promo- tion.