俯卧位通气联合肺复张对重度急性呼吸窘迫综合征患者预后的影响分析

Analysis of the Influence of Prone Position Ventilation Combined with Lung Recruitment on the Prognosis of Patients with Severe Acute Respiratory Distress Syndrome

目的对重度急性呼吸窘迫综合征患者采用俯卧位通气联合肺复张治疗对患者预后的影响进行探讨。方法方便选取该院2016年2月—2018年2月期间收治的40例重度急性呼吸窘迫综合征患者,随机分为观察组采用俯卧位通气联合肺复张治疗与对照组给予俯卧位通气治疗,各20例,对比两组患者治疗效果及预后情况。结果治疗后,观察组PaO2、FiO2、PaO2/FiO2、PEEP等呼吸动力学指标评分别为(88.24±9.43)mmHg、(0.48±0.07)%、(352.71±32.76)mmHg、(7.89±1.72)cmH2O,对照组分别为(80.67±8.85)mmHg、(0.62±0.11)%、(322.05±27.96)mmHg、(10.92±2.67)cmH2O,观察组均明显优于对照组,差异有统计学意义(t=4.261、3.594、5.718、4.833,P<0.05);机械通气时间、ICU留置时间方面,观察组分别为(12.19±5.37)d、(20.86±14.75)d,均明显低于对照组的(19.96±7.13)d、(27.24±20.51)d,差异有统计学意义(t=3.796、3.628,P<0.05);两组不良事件发生率方面,观察组为10.00%,对照组为30.00%,观察组明显低于对照组,差异有统计学意义(χ^2=9.927,P<0.05)。结论对重症急性呼吸窘迫综合征患者采用俯卧位通气联合肺复张治疗,可有效改善患者呼吸动力学水平,预后效果较好。

Objective To investigate the effect of prone position ventilation combined with lung recruitment on the prognosis of patients with severe acute respiratory distress syndrome.Methods 40 patients with severe acute respiratory distress syndrome admitted to our hospital from February 2016 to February 2018 were convenient selected and randomly divided into observation group with prone position ventilation combined with lung recruitment and control group with prone position ventilation.20 cases each,comparing the treatment effect and prognosis of the two groups of patients.Results After treatment,the respiratory kinetic parameters of PaO2,FiO2,PaO2/FiO2,and PEEP in the observation group were(88.24±9.43)mmHg,(0.48±0.07)%,(352.71±32.76)mmHg,(7.89±1.72)cmH2O.The control group was(80.67±8.85)mmHg,(0.62±0.11)%,(322.05±27.96)mmHg,(10.92±2.67)cmH2O,and the observation group was significantly better than the control group.The difference was statistically significant(t=4.261,3.594,5.718,4.833,P<0.05).The mechanical ventilation time and ICU indwelling time were(12.19±5.37)d and(20.86±14.75)d,respectively,which were significantly lower than the control group(19.96±7.13)d,(27.24±20.51)d,the difference was statistically significant(t=3.796,3.628,P<0.05);the incidence of adverse events in the two groups was 10.00%in the observation group.The control group was 30.00%,and the observation group was significantly lower than the control group.The difference was statistically significant(χ^2=9.927,P<0.05).Conclusion The treatment of patients with severe acute respiratory distress syndrome with prone position ventilation combined with lung recruitment can effectively improve the patient's respiratory dynamics and have a good prognosis.