俯卧位通气联合肺复张对ARDS的疗效

Efficacy of prone position ventilation combined with lung reexpansion on patients with acute respiratory distress syndrome

目的探讨俯卧位通气联合肺复张对急性呼吸窘迫综合征(ARDS)的疗效。方法 ARDS患者42例随机均分为两组:对照组采用常规机械通气基础上运用压力控制法肺复张策略;试验组采用俯卧位机械通气基础上运用压力控制法肺复张策略。比较两组患者分组后1、2、6h肺复张后HR、CVP、MAP、PaO_2、氧合指数(OI)、气道平台压(Pplat)和静态肺顺应性(Clst)的变化。结果试验组PaO_2和OI较对照组改善更为明显(P<0.05);两组肺复张前后Pplat、Clst比较差异无统计学意义(P>0.05)。两组肺复张后HR、CVP、MAP比较差异亦无统计学意义(P>0.05)。结论俯卧位联合压力控制法肺复张能更有效改善ARDS患者的氧合状态,且对血流动力学影响小。

Objective To investigate the efficacy of prone position ventilation combined with lung reexpansion on the patients with acute respiratory distress syndrome （ARDS ） .Methods Forty-two patients with ARDS were equally and randomly divided into two groups of A [received prone position ventilation combined with lung reexpansion by pressure-controlled ventilation （PCV ）] and B（received conventional mechanical ventilation combined with lung reexpansion by PCV as the control） .The changes of HR ,CVP ,MAP ,PaO2 ,OI ,Pplat and Clst at 1 ,3 and 6 hours during ventilation were compared between two groups .Results The improvements of PaO2 and OI were more in group A than those in group B（P〈0 .05） .There were no significant differences in Pplat and Clst before and after lung reexpansion between two groups （P〉0 .05） .So did in HR ,CVP and MAP after lung reexpansion between two groups （ P〉0 .05 ） .Conclusion Prone position ventilation combined with lung reexpansion by PCV can effectively improve oxygenation with little effect on hemodynamics in the patients with ARDS .