摘要
Abstract
Objective:To explore the influence of supine position(SP) and prone position(PP) ventilation combined with vibration sputum (VS) on hemodynamics,oxygenation and respiratory mechanics in patients with acute respiratory distress syndrome (ARDS).Methods:A total of 60 cases of ARDS patients with mechanical ventilation were randomly divided into SP ventilation group and PP ventilation group,SP ventilation combined with VS(SP+ VS) group,and PP ventilation combined with VS(PP+ VS) group,15 cases in each group.Heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),pulse oxygen saturation(SPO2),arterial blood co2 partial pressure(PaCO2),arterial blood oxygen partial pressure(PaO2),oxygenation index(PaO2/ FiO2),breathing rate (RR),the airway peak pressure(PIP),mean airway pressure (Pmean),static lung co mpliance(Cst),and nursing complications at 5 different time points:before change the position(T0),1 h (T1),2 h (T2),and 4 h (T3) after change the position [after the VS treatment in the(SP+VS) group and(PP+ VS) group],and 1h (T4) after converting of SP were observed.The arterial oxygen partial pressure change(PaO2)＞10 m mHg was used as the effective standard.Results:There was no influence of the 4 groups of patients on HR,MAP,CVP,RR,PaCO2,Pmean and Cst(P＞0.05) after the position changing.SPO2,PaO2,and PaO2/FiO2 increased to different extent,and the improvement effect of oxygenation state in the 4 groups showed(PP+VS)＞PP＞(SP+VS)＞SP.The difference between groups,(PP+VS) group and (SP+VS) group,PP group and SP group,was statistically significant (P＜0.05);while there was no difference between(PP+ VS) group and PP group,and (SP + VS) group and SP group(P＞0.05).Conclusions:Compared with PP ventilation and SP ventilation,PP ventilation combined with VS was better to improve the oxygenation of patients with ARDS.Patients could maintain a stable circular function in the treatment when taking this kind of body posture,with no obvious change in the breath,and no obvious adverse complications occurred.关键词
急性呼吸窘迫综合征/俯卧位通气/振动排痰/氧合指标/并发症/体位/呼吸力学/血流动力学Key words
acute respiratory distress syndrome/prone position ventilation/vibration sputum/oxygenation index/complications/body posture/respiratory mechanics/hemodynamics分类
医药卫生
