不同体位肺复张对ARDS患者氧合及血流动力学的影响

发布时间：2018-04-24 13:20

本文选题：急性呼吸窘迫综合征 + 体位　；参考：《新疆医科大学》2013年硕士论文

【摘要】：目的：评价俯卧位肺复张对改善急性呼吸窘迫综合征(ARDS)患者氧合指数、血流动力学的影响。方法：将71例收治ICU的ARDS患者先后行仰卧位肺复张和俯卧位肺复张,中间间隔洗脱期,收集两种体位下肺复张前后血流动力学指标,血气分析并计算PaO2/FiO2,监测肺复张前、肺复张后1h血流动力学和氧合的变化。结果：(1)两种体位肺复张后,SP02均显著升高(0.05),俯卧位肺复张后SP02较仰卧位肺复张后更高(P0.05)；(2)仰卧位和俯卧位肺复张后PaO2/FiO2均升高,(0.05),且俯卧位肺复张前后PaO2/FiO2也均高于仰卧位肺复张前后(P0.05)；(3)仰卧位和俯卧位肺复张后1小时HR、MAP、CI、SVRI、CVP无差别,两种体位间比较无显著差异。结论：仰卧位肺复张和俯卧位肺复张后的氧合指数明显高于肺复张前,俯卧位比仰卧位肺复张更能改善患者氧合,肺复张对血流动力学影响不明显。
[Abstract]:Objective: to evaluate the effect of prone lung retraction on the improvement of oxygenation index and hemodynamics in ARDS patients with acute respiratory distress syndrome (ARDS). Methods: 71 patients with ARDS admitted to ICU were treated with supine lung reexpansion in prone position, interseptal elution stage, hemodynamic indexes before and after reexpansion of lung in two different postures, blood gas analysis and calculation of Pao _ 2 / FiO _ 2, and monitoring before pulmonary reexpansion. Changes of hemodynamics and oxygenation at 1 hour after lung reexpansion. Results 1) SP02 increased significantly after reexpansion of lung in both positions. SP02 in prone position was higher than that in supine position (P 0.05). PaO2/FiO2 in supine position and prone position was higher than that in supine position. PaO2/FiO2 in prone position was also higher than that in supine position. In the supine position and the prone position, there was no difference in the CVP between the supine position and the prone position. There was no significant difference between the two postures. Conclusion: the oxygenation index of the lung in the supine position was significantly higher than that in the supine position, and the oxygenation index in the prone position was significantly higher than that in the supine position. The effect of pulmonary retraction on hemodynamics was not obvious.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563.8

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