摘要
目的探讨重症肺部感染低氧血症患者实施俯卧位肺复张对患者氧合指数、肺内分流、血流动力学的影响。方法选取2015年3月~2017年3月我院收治的88例重症肺部感染低氧血症患者,按患者肺复张体位分为俯卧组(n=44,俯卧位肺复张)和仰卧组(n=44,仰卧位肺复张),比较两组患者的治疗效果及安全性状况。结果俯卧组患者治疗后血氧饱和度(SpO_2)、氧合指数(PaO_2/FiO_2)、心脏指数(CI)、每搏指数(SVI)、中心静脉压(CVP)、全身射血分数(GEF)分别为(102.9±2.7)%、(398.2±43.8)、(3.6±0.4)L/min、(32.7±3.4)、(3.9±1.1)cm H2O、(26.8±2.5)%,明显高于仰卧组[(95.2±2.6)%、(328.3±42.7)、(3.3±0.5)L/min、(30.5±3.5)、(3.2±0.7)cm H_2O、(24.1±2.7)%],差异均有统计学意义(P<0.05);俯卧组患者治疗后肺内分流(Qs/Qt)、全身血管阻力(SVRI)分别为(9.5±0.8)%、(10.8±1.3)%,明显低于仰卧组[(11.2±1.3)%、(12.2±1.5)%],差异有统计学意义(P<0.05)。俯卧组患者治疗后不良反应发生率为6.8%与仰卧组的9.1%比较差异无统计学意义(P>0.05)。结论重症肺部感染低氧血症患者实施俯卧位肺复张可改善患者PaO_2/FiO_2、Qs/Qt,减少对血流动力学的影响。
Objcetive To explore the effect of prone position of lung recruitment on oxygenation index in patients with hypoxemia in patients with severe pulmonary infection,intrapulmonary shunt,hemodynamics.nethods 88 cases of hypoxemia in patients with severe pulmonary infection from March 2015 to March 2017 in our hospital,according to patients with atelectasis were divided into prone group （n=44,pulmonary recruitment in prone position） and supine group （n=44, supine lung recruitment）,the status of the therapeutic effects and safety of statistics of the two groups were compared. Results The prone group after treatment in patients with SpO2,PaO2/FiO2, CI,SVI,CVP,GEF respectively （102.9±2.7）% and （398.2±43.8）,（3.6±0.4） L/min,（32.7±3.4）,（3.9±1.1） cmH2O,（26.8±2.5）%,significantly higher than the supine group [（95.2±2.6）% and （328.3±42.7）,（3.3±0.5） L/min,（30.5±3.5）,（3.2±0.7） cmHzO,（24.1±2.7）],the difference was statistically significant （P〈0.05）;the prone group after treatment in patients with Qs/Qt and SVRI respectively （9.5±0.8）% and （10.8±1.3）%,significantly lower than the supine group [（11.2±1.3）% and （12.2±1.5）%],the difference was statistically significant （P〈0.05）.The incidence of side effects in the prone group after treatment was 6.8%,compared with that in the supine group （9.1%）,and there was no significant difference （P〉0.05）.Conelusion Severe pulmonary infection prone atelectasis patients can improve the oxygenation index,the implementation of hypoxemia in patients with intrapulmonary shunt and reduce the effects on hemodynamics.
出处
《中国当代医药》
2017年第29期21-23,共3页
China Modern Medicine
关键词
重症肺部感染
低氧血症
俯卧位肺复张
氧合指数
肺内分流
血流动力学
Severe pulmonary infection
Hypoxemia
Prone position lung recruitment
Oxygenation index
Intrapulmonary shunt
Hemodynamics
作者简介
邹新辉（1982-），男，硕士，主治医师，研究方向：重症医学、神经系统重症疾病及重症感染
通讯作者
