俯卧位通气在治疗重症ARDS中的疗效

Effect of prone position ventilation in the treatment of severe acute respiratory distress syndrome

目的:研究俯卧位通气在治疗重症急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)中的临床效果。方法:选择2013年1月至2016年11月收治的重症ARDS患者160例,随机分为观察组和对照组,每组80例。对照组采用仰卧位通气治疗,观察组采用俯卧位通气治疗,比较两组患者动脉氧分压(oxygen partial pressure,Pa O2)/吸入气氧浓度(fraction of inspire O2,Fi O2),比较两组患者入住ICU的时间、死亡率、机械通气时间和不良反应发生率。结果:观察组第5 d和第7 d的Pa O2/Fi O2均高于对照组(P<0.05);观察组的入住ICU时间和机械通气时间均低于对照组(P<0.05);观察组的死亡率和不良反应发生率均低于对照组(P<0.05)。结论:俯卧位通气可以有效减轻重症ARDS患者的缺氧程度,改善疾病预后,具有较好的临床治疗效果。

Objective： To study the effect of prone position ventilation in the treatment of severe acute respiratory distress syndrome（ ARDS）.Methods： 160 patients with severe ARDS hospitalized from January,2013 to November,2016 were randomly divided into the observation group and the control group,80 cases in each group. The control group was treated with supine position ventilation while the observation group was treated with prone position ventilation,with oxygen partial pressure（ Pa O2）/fraction of inspire O2（ Fi O2）,time of ICU stay,mortality,duration of mechanical ventilation,and incidence of side effects compared between the two groups. Results： The Pa O2/Fi O2 of the observation group was significantly higher than that of the control group on the 5th day and the 7th day（ P〈0. 05）. The time of ICU stay and mechanical ventilation in the observation group were significantly shorter than those in the control group（ P〈0. 05）. The mortality and adverse reaction rate in the observation group were significantly lower than those in the control group（ P〈0. 05）. Conclusion： Prone position ventilation,which is clinically effective,can significantly improve oxygenation and prognosis of the patients with severe ARDS.