急性呼吸窘迫综合征在肺灌洗后行俯卧位通气的疗效观察

目的观察急性呼吸窘迫综合征患者在肺灌洗后行俯卧位通气治疗对氧合、肺力学的影响及作用。方法20例急性呼吸窘迫综合征患者在肺灌洗后行俯卧位通气治疗,分别监测治疗前、治疗后的氧分压、气道峰压、炎症介质的变化,观察治疗前后患者胸部CT影像学的变化。结果经过肺灌洗和俯卧位通气2 h后氧分压明显升高、气道峰压显著下降,俯卧位通气1 d后胸部CT检查显示肺实变区部分消失,炎症介质检验显示明显下降。结论肺灌洗后行俯卧位通气可改善早期急性呼吸窘迫综合征患者的氧合,有效改善肺部炎症。

Observation on the effect of prone position ventilation after lung lavage for patients with acute respiratory distress syndrome

Objective To observe the effect of prone position ventilation after lung lavage for patients with acute respiratory distress syndrome on oxygen transfer,lung dynamic and function. Method Give prone position ventilation after lung lavage to patients with acute respiratory distress syndrome. Test the change of oxygen partial pressure, peak pressure of airway and inflammatory mediators,observe the change of chest CT image before and after treatment. Result Oxygen partial pressure rises and peak pressure of airway drops obviously 2 h after lung lavage and prone position ventilation. Chest CT shows that lung consolidation disappears partly and inflammatory mediators decrease obviously 1 d after prone position ventilation. Conclusion Prone position ven- tilation after lung lavage can improve the oxygen transfer and reduce the lung inflammatory mediators for patients with acute respi- ratory distress syndrome.