不同卧位对新生儿机械通气的效果评价

Evaluation on the Effects of Different Lying Positions for Neonatal Mechanical Ventilation

目的探讨仰卧位、侧卧位、俯卧位对新生儿机械通气的效果。方法选取我院2014年1月至2015年6年期间收治的40例机械通气的新生儿,以仰卧位为基础体位,每3小时更换体位,在改变体位后1小时观察新生儿的PaO_2、PaO_2/FiO_2、PaO_2/PAO_2、A-aDO_2、心率(HR)、TcSO_2、PaCO_2指标,分析机械通气时的最佳体位,减少耗氧。结果与仰卧位和侧卧位比较,机械通气时俯卧位的PaO_2、PaO_2/FiO_2、PaO_2/PAO_2和A-aDO_2均明显较高,HR明显较低,TcSO_2明显较高,差异均具有统计学意义(P均<0.05)。三组的PaCO_2比较差异无统计学意义(P>0.05)。结论对机械通气的新生儿采取俯卧位为主要体位进行治疗可以明显改善其氧合指标和心率指标,提高临床治疗效果,值得在临床上推广应用。

Objective To explore the effects of supine position, lateral position and prone position for neonatal mechanicalventilation. Methods 40 cases of newborns with mechanical ventilation in our hospital from January 2014 to June 2015 were selected. Withthe supine position as the basic position, the pasition was changed every three hours. An hour after the change of position, the indicators ofPaO2, PaOJFiO2, PaOJPAO2, A-aDO2, heart rate （HR）, TcSO2 and PaCO2 of newborns were observed, and the optimal position of mechanicalventilation was analyzed to reduce the oxygen consumption. Results Compared with supine position and lateral position, the PaO2,PaO2/FiO2, PaOJPAO2 and A-aDO2 of prone position in the mechanical ventilation were significantly higher, HR was significantly lower andTcSO2 was significantly higher, with statistical differences （all P〈0.05）. No statistical difference was found in the PaCO2 among three groups（P 〉0.05）. Conclusions As the main treatment position, the prone position in the newborns with mechanical ventilation can significantlyimprove the oxygenation indicators and HR, and improve treatment effect, which is worthy of clinical promotion and application.