俯卧位机械通气治疗慢性阻塞性肺病患者脱机困难对氧合的影响

Prone Position Ventilation for the Treatment of Patients with Chronic Obstructive Pulmonary Disease on Difficult Weaning Ventilation

目的:观察俯卧位机械通气在慢性阻塞性肺病(COPD)脱机困难患者中应用对氧合的影响。方法:选取2015年7月-2016年7月笔者所在科室60例COPD患者作为研究对象,根据不同通气方式分为观察组和对照组各30例,对照组采取仰卧位机械通气,观察组采用俯卧位机械通气。结果:出院时,两组患者PaCO_2及PaO_2/Fio_2水平均高于入组时,且观察组患者PaCO_2及PaO_2/Fio_2水平明显高于对照组(P<0.05);两组患者SpO_2及痰液引流量均显著高于入组时,且观察组患者SpO_2及痰液引流量均明显高于对照组(P<0.05)。结论:俯卧位机械通气在COPD脱机困难患者中的效果优于仰卧位,更利于改善患者氧合状态,值得在临床中广泛推广应用。

Objective：To observe the effect of prone position ventilation in chronic obstructive pulmonary disease（COPD）patients of difficult weaning ventilation. Methods：From July 2015 to July 2016,60 cases patients with COPD as the research object,according to the different modes of ventilation were divided into observation group and control group with 30 cases in each group. Patients in the control group were treated with supine mechanical ventilation,while patients in the observation group were treated with prone position ventilation. Results：After treatment, PaCO2 and PaO2/FiO2 were significantly higher in both groups. PaCO2 and PaO2/FiO2 in the observation group were higher than those of the control group（P〈0.05）. SpO2 and sputum drainage in both groups were significantly higher than before treatment. SpO2 and sputum of patients with drainage in the observation group were higher than those of the control group（P〈0.05）. Conclusion：The prone position is much better in COPD patients with mechanical ventilation in difficult weaning,more conducive to improve oxygenation in patients,worthy of clinical application.