仰卧位和俯卧位肺复张对重症肺炎患者治疗效果的比较

目的：评价仰卧位、俯卧位肺复张对重症肺炎患者血流动力学、氧合的影响。方法：将90例重症肺炎患者随机分为仰卧位肺复张组、俯卧位肺复张组、仰卧位肺复张＋俯卧位肺复张组。监测肺复张前、肺复张后5 min、复张后1 h血流动力学和氧合的变化。结果：两种体位下肺复张前和肺复张后5 min中心静脉压（CVP）、心脏指数（CI）均降低，差异均有统计学意义（P＜0．05），但肺复张后1 h血流动力学指标已接近肺复张前；两种体位肺复张前后氧合指数（ PaO2/FiO2）均升高，差异均有统计学意义（ P＜0.05），且俯卧位肺复张后1h氧合改善程度较仰卧位肺复张后1h明显。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。

Effects of prone and supine position ventilation combined with recruitment maneuver on patients with severe pneumonia

Objective： To explore the effects of prone and supine position ventilation combined with recruitment maneuver on patients with severe pneumonia .Methods：90 cases were randomly divided into three groups , including prone position group , supine position group , prone position combined supine position group .Results：Compared with data before recruitment maneuver , CI and CVP were decreased significantly after recruitment maneuver 5 minutes in＆amp;nbsp;both supine position and prone position group （P〈0.05）, then they returned to the base level an hour later ,but significant differences in PaO 2/FiO2 were found between before and after recruitment maneuver when patients ＆#39;position was changed , and it suggest that recruitment maneuver improved oxygenation more effectively in prone compared with supine position . Conclusions： Prone and supine position ventilation combined with recruitment maneuver significantly improves oxygenation in severe pneumonia patients ,but slightly changes hemodynamics .