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

【摘要】：目的：評(píng)價(jià)俯臥位肺復(fù)張對(duì)改善急性呼吸窘迫綜合征(ARDS)患者氧合指數(shù)、血流動(dòng)力學(xué)的影響。方法：將71例收治ICU的ARDS患者先后行仰臥位肺復(fù)張和俯臥位肺復(fù)張,中間間隔洗脫期,收集兩種體位下肺復(fù)張前后血流動(dòng)力學(xué)指標(biāo),血?dú)夥治霾⒂?jì)算PaO2/FiO2,監(jiān)測肺復(fù)張前、肺復(fù)張后1h血流動(dòng)力學(xué)和氧合的變化。結(jié)果：(1)兩種體位肺復(fù)張后,SP02均顯著升高(0.05),俯臥位肺復(fù)張后SP02較仰臥位肺復(fù)張后更高(P0.05)；(2)仰臥位和俯臥位肺復(fù)張后PaO2/FiO2均升高,(0.05),且俯臥位肺復(fù)張前后PaO2/FiO2也均高于仰臥位肺復(fù)張前后(P0.05)；(3)仰臥位和俯臥位肺復(fù)張后1小時(shí)HR、MAP、CI、SVRI、CVP無差別,兩種體位間比較無顯著差異。結(jié)論：仰臥位肺復(fù)張和俯臥位肺復(fù)張后的氧合指數(shù)明顯高于肺復(fù)張前,俯臥位比仰臥位肺復(fù)張更能改善患者氧合,肺復(fù)張對(duì)血流動(dòng)力學(xué)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(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R563.8

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本文編號(hào)：1796808