俯卧位与仰卧位机械通气治疗对中重度ARDS患者血气分析指标及血流动力学指标的影响比较

Comparison of the Effects of Mechanical Ventilation in Prone and Supine Positions on Blood Gas Analysis Indicators and Hemodynamics Indicators in Patients with Moderate to Severe ARDS

目的探讨俯卧位与仰卧位机械通气治疗对中重度急性呼吸窘迫综合征(ARDS)患者血气分析指标及血流动力学指标的影响。方法选取2022年1月—2023年12月临沂市中心医院收治的62例中重度ARDS患者为研究对象,按随机数字表法将其分为仰卧组和俯卧组,各31例。仰卧组采取常规半卧位机械通气治疗,俯卧组采取俯卧位机械通气治疗。对比两组的血气分析指标、血流动力学指标及并发症发生情况。结果治疗3 d后,两组氧合指数、血氧分压水平均高于治疗前,且俯卧组均高于仰卧组,两组二氧化碳分压水平均低于治疗前,且俯卧组二氧化碳分压水平低于仰卧组,差异有统计学意义(P<0.05);两组心率比较,差异无统计学意义(P>0.05);两组中心静脉压、平均动脉压水平均高于治疗前,且俯卧组均高于仰卧组,差异有统计学意义(P<0.05)。两组并发症发生率对比,差异无统计学意义(P>0.05)。结论中重度ARDS患者采取俯卧位机械通气治疗,其血气分析指标及血流动力学指标改善效果均优于仰卧位机械通气,且安全性良好。

Objective To investigate the effects of mechanical ventilation in prone and supine positions on blood gas analysis indicators and hemodynamics indicators in patients with moderate to severe acute respiratory distress syndrome(ARDS).Methods A total of 62 patients with moderate to severe ARDS admitted to Linyi Central Hospital from January 2022 to December 2023 were selected as the research subjects,according to the random number table method,they were divided into a supine group and a prone group,with 31 cases in each group.The supine group received conventional semi recumbent mechanical ventilation treatment,while the prone group received prone mechanical ventilation treatment.Compare the blood gas analysis indicators,hemodynamic indicators and occurrence of complications between the two groups.Results After 3 days of treatment,the levels of oxygenation index,partial pressure of oxygen in both groups was higher than before treatment,and the prone group were higher than those in the supine group,the levels of partial pressure of carbon dioxide in both groups were lower than before treatment,and the prone group was lower than those in the supine group,the differences were statistically significant(P<0.05);there was no statistically significant difference in heart rate between the two groups(P>0.05);the levels of central venous pressure and mean arterial pressure in both groups were higher than before treatment,and the prone group were higher than the supine group,the differences were statistically significant(P<0.05).Comparison of incidence of complications between two groups,the difference was not statistically significant(P>0.05).Conclusion Patients with moderate to severe ARDS treated with prone mechanical ventilation showed better improvement in blood gas analysis indicators and hemodynamic indicators compared to supine mechanical ventilation,and had good safety.