俯卧位联合反Trendelenburg位对改善ARDS患者氧合功能作用的研究

Effects of prone position combined with reverse Trendelenburg position on oxygenation among acute respiratory distress syndrome patients

目的观察俯卧位和反Trendelenburg位方法结合改善ARDS低氧血症的效果以及对患者呼吸力学的影响。方法采用便利抽样法选取2017年1—12月在绍兴文理学院附属医院ICU住院的ARDS患者为研究对象。按照随机数字表法将入组的20例患者分为A、B两组,A组患者采用先俯卧位2 h,后俯卧位联合反Trendelenburg位6 h的治疗方案。B组患者采用先俯卧位联合反Trendelenburg位2 h,后俯卧位6 h的治疗方案。在治疗过程中评价患者肺通气功能以及呼吸力学的变化。结果两组ARDS患者氧合指数不同时间、不同分组以及时间与分组的交互作用有统计学意义(P<0.01);干预后2 h,B组氧合指数高于A组,但差异无统计学意义(P>0.05)。干预后1、5、8 h A组氧合指数均高于B组,差异均有统计学意义(P<0.05)。A组氧合指数随时间逐渐增加,B组前2 h增加,随后降低。两组患者呼吸力学的差异无统计学意义(P>0.05)。结论俯卧位联合反Trendelenburg位可以改善ARDS患者的氧合功能。

ObjectiveTo explore the effects of prone position combined with reverse Trendelenburg position on improving hypoxemia and respiratory mechanics of acute respiratory distress syndrome(ARDS)patients.MethodsFrom January 2017 to December 2017,we selected ARDS inpatients in Intensive Care Unit at Affiliated Hospital of Shaoxing University as subjects by convenience sampling.The total of 20 patients were divided into group A and group B with the method of random number table.Patients of group A adopted prone position for two hours firstly,and then they adopted prone position combined with reverse Trendelenburg position for six hours.Patients of group B adopted prone position combined with reverse Trendelenburg position for two hours firstly,and then they adopted prone position for six hours.During treatment,we assessed the function of pulmonary ventilation and respiratory mechanics of patients.ResultsThere were statistical differences in different time,different groups and interaction between time and groups among ARDS patients between two groups(P<0.01).Two hours after intervention,the oxygenation index of group B was higher than that of group A with no statistical difference(P>0.05).One,five and eight hours after intervention,the oxygenation indexes of group A were higher than those of group B with statistical differences(P<0.05).The oxygenation index of group A increased with time,and that of group B increased two hours after intervention and then reduced.There was no statistical difference in the respiratory mechanics of patients between two groups(P>0.05).ConclusionsProne position combined with reverse Trendelenburg position can improve the oxygenation of ARDS patients.