改良俯卧位对俯卧位通气临床疗效及并发症的影响

Effect of modified prone position on clinical efficacy and complications of prone position ventilation

目的观察改良俯卧位对俯卧位通气(PPV)临床疗效及并发症的影响。方法将该院呼吸和危重症医学科行PPV的52例患者随机分为对照组和实验组各26例,对照组应用常规方法进行PPV,实验组采用改良俯卧位进行PPV。比较两组患者PPV的临床效果和并发症发生情况。结果两组间俯卧位前和俯卧位后12 h的氧合指数无明显差异(P>0.05);两组患者俯卧位后12 h的氧合指数均较各组俯卧位前明显改善(P<0.05);两组患者气管插管脱出、血流动力学显著波动、误吸和面部水肿的发生率无显著差异(P>0.05);实验组皮肤压疮的发生率明显低于对照组(P<0.05)。结论改良俯卧位对PPV的临床疗效无显著影响,但可以降低皮肤压疮的发生率。

【Objective】To observe the effect of modified prone position on the clinical efficacy and complications of prone position ventilation.【Methods】Fifty-two patients in the department of respiratory and critical care medicine of Xiangya Hospital of Central South University were evenly divided into the control group and the experimental group.The control group received routine prone position ventilation,and the experimental group received modified prone position ventilation.The clinical effects and complications of prone position ventilation were compared between the two groups.【Results】The oxygenation indexes before the prone position and after 12 h of prone position between the two groups have no obvious difference(P>0.05),but the oxygenation indexes(PaO2/FiO2)after 12 h prone position in each group have improved significantly compared with those before the prone position respectively(P<0.05).The incidence of tracheal intubation of emergence,hemodynamic fluctuations,aspiration and facial edema have no significant difference between the two groups(P>0.05).The incidence of pressure ulcers was significantly lower in the experimental group than in the control group(P<0.05).【Conclusion】Modified prone position has no significant effect on the clinical efficacy of prone position ventilation,but can reduce the incidence of skin pressure ulcers.