俯卧位通气在重度ARDS患者中的应用效果分析

Effect of Prone Position Ventilation in Severe ARDS Patients

目的探讨在重度急性呼吸窘迫综合征(Acute Respiratory Distress Syndrome,ARDS)患者中,应用俯卧位通气治疗改善ARDS患者氧合状态的效果。方法选取2017年11月—2019年11月入住本院重症医学科符合诊断重度ARDS患者共102例作为研究对象,采用随机数字法分成试验组(采用俯卧位通气治疗)51例,对照组(采用仰卧位通气治疗)51例。对比两组在pH值、PaO_(2)、PaCO_(2)、氧合指数(PaO_(2)/FiO_(2))、血氧饱和度(SpO_(2))、心率(HR)等的变化;对比两组在不良事件发生率的变化。结果经治疗后,两组在PaO_(2)、氧合指数(PaO_(2)/FiO_(2))、血氧饱和度(SpO_(2))、心率(HR)方面差异具有统计学意义(P<0.05);两组在并发症发生率方面,差异具有统计学意义(P<0.05);两组在pH值、PaCO_(2)方面对比,差异无统计学意义(P>0.05)。结论对于重度ARDS患者,通过俯卧位通气治疗,可有效改善患者氧合状态,促使症状缓解,加强治疗效果。但是在并发症预防方面还有待改善。

Objective To study the effect of prone position ventilation in patients with severe ARDS(acute response syndrome)to improve oxygenation status in ARDS patients.Methods From November 2017 to November 2019,a total of 102 patients with severe ARDS who were admitted to the department of critical medicine of our hospital were selected as the research objects.They were randomly divided into the experimental group(51 patients were treated with ventilation in prone position)and the control group(51 patients were treated with ventilation in supine position).The changes of pH,PaO_(2),PaCO_(2),oxygenation index(PaO_(2)/FiO_(2)),SpO_(2),heart rate(HR)and the incidence of adverse events were compared between the two groups.Results After treatment,the difference between two groups in PaO_(2),oxygenation index(PaO_(2)/FiO_(2)),blood oxygen saturation(SpO_(2)),heart rate(HR)were statistically significant(P<0.05);the two groups in the incidence of complications,the difference was statistically significant(P<0.05);the two groups in the pH value,PaCO_(2),the difference was not statistically significant(P>0.05).Conclusion For patients with severe ARDS,ventilation in prone position can effectively improve the patients'oxygenation status,promote the relief of symptoms and strengthen the treatment effect.However,the prevention of complications needs to be improved.