本文選題：急性呼吸窘迫綜合征 + 體位　； 參考：《新疆醫(yī)科大學》2013年碩士論文

【摘要】：目的：評價俯臥位肺復張對改善急性呼吸窘迫綜合征(ARDS)患者氧合指數(shù)、血流動力學的影響。方法：將71例收治ICU的ARDS患者先后行仰臥位肺復張和俯臥位肺復張,中間間隔洗脫期,收集兩種體位下肺復張前后血流動力學指標,血氣分析并計算PaO2/FiO2,監(jiān)測肺復張前、肺復張后1h血流動力學和氧合的變化。結果：(1)兩種體位肺復張后,SP02均顯著升高(0.05),俯臥位肺復張后SP02較仰臥位肺復張后更高(P0.05)；(2)仰臥位和俯臥位肺復張后PaO2/FiO2均升高,(0.05),且俯臥位肺復張前后PaO2/FiO2也均高于仰臥位肺復張前后(P0.05)；(3)仰臥位和俯臥位肺復張后1小時HR、MAP、CI、SVRI、CVP無差別,兩種體位間比較無顯著差異。結論：仰臥位肺復張和俯臥位肺復張后的氧合指數(shù)明顯高于肺復張前,俯臥位比仰臥位肺復張更能改善患者氧合,肺復張對血流動力學影響不明顯。
[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.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R563.8

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