肺内源性ARDS俯卧位通气与传统呼吸机治疗的效果观察

摘要

Objective:To investigate and compare the effect of prone ventilation and traditional ventilator therapy on pulmonary endogenous ARDS. Methods: 89 patients with pulmonary endogenous acute respiratory distress syndrome were randomely selected and divided into observation group and control group according to single-blind method. The control group was treated with traditional ventilator, and the observation group was given with prone ventilation on the basis of the control group.The oxygenation index, dead space fraction, chest film absorption, case fatality rate, prognostic indicators (ventilator use time, tubal time, ICU hospitalization time, total hospitalization time) were compared between the two groups. Results: After treatment, the oxygenation index of the observation group was significantly higher than that of the control group. The oxygenation index at 4 h after treatment (97.21±9.13) mmHg, 6 h after treatment (98.57±6.18) mmHg and 8 h after treatment (105.17±4.68) mmHg in the observation group were significantly higher than in the control group. The 4 h after treatment (0.41±0.05) , 6 h after treatment (0.41±0.04) and 8 h after treatment (0.41±0.06) were significantly lower than the control group. The prognostic index of the observation group was better than the control group. The mortality rate of the observation group was 15.00％, which was also significantly lower than that of the control group. Conclusion: The long duration of prone ventilation can improve the pulmonary endogenous acute respiratory distress syndrome, improve the oxygenation index, and reduce the mortality, which is worth of popularizing application.%目的:探讨肺内源性ARDS俯卧位通气与传统呼吸机治疗的效果, 并进行对比.方法:随机选取89例肺内源性急性呼吸窘迫综合征的患者, 根据单盲法均分为观察组与对照组.对照组给予传统呼吸机治疗, 观察组在对照组基础上给予俯卧位通气, 比较两组的氧合指数、死腔分数、胸片吸收情况、病死率、预后指标 (呼吸机使用时间、脱管时间、ICU住院时间、总住院时间).结果:观察组治疗后氧合指数均显著高于对照组;观察组治疗后4h氧合指数 (97.21±9.13) mmHg、治疗后6h (98.57±6.18) mmHg、治疗后8h (105.17±4.68) mmHg均显著高于对照组;治疗后4h死腔分数 (0.41±0.05) 、治疗后6h (0.41±0.04) 、治疗后8h (0.41±0.06) 均显著低于对照组.观察组预后指标优于对照组;观察组病病死率15.00％也显著小于对照组;观察组胸片炎症吸收情况为22.35％显著高于对照组.结论:通过长时间的俯卧位通气可改善肺内源性急性呼吸窘迫综合征, 改善氧合指数, 降低病死率, 值得推广应用.