俯卧位通气在慢性阻塞性肺病患者中的应用

目的:慢性阻塞性肺病患者有不同程度的低氧血症,俯卧位可以通过改善机体通气血流比例而提高氧合能力。本研究将俯卧位应用于急性加重期慢性阻塞性肺病患者,以探讨俯卧位与慢性阻塞性肺病患者动脉血氧分压的关系。方法:前瞻性研究,俯卧位结合药物治疗患者42例(男性23例,女性19例,平均年龄62.64±6.34岁),药物治疗患者42例(男性20例,女性22例,平均年龄64.10±7.30岁),两组患者分别于治疗前、治疗后第八天测定动脉血氧分压水平,反映动脉血氧分压的变化,探讨俯卧位对动脉血氧分压的影响。俯卧位结合药物治疗患者中的13名志愿者,还要在第一天俯卧后变回到仰卧前,第二、四、六天俯卧前1小时测定其动脉血氧分压,反映患者由俯卧位变回仰卧位后动脉血氧分压的变化及动脉血氧分压变化和俯卧时间之间的关系。结果:(1)俯卧位通气结合药物治疗患者动脉血氧分压治疗前后比较有显著差异(P<0.05)。(2)药物治疗患者动脉血氧分压治疗前后比较有显著差异(P<0.05)。(3)俯卧位通气结合药物治疗和药物治疗患者治疗后动脉血氧分压的变化程度两组间比较有显著差异(0.0010.01或P>0.05)。(5)俯卧位通气结合药物治疗患者动脉血氧分压随俯卧时间延长逐渐升高,二者之间存在正相关(P<0.05)。部分患者(28%)俯卧1天内出现动脉血氧分压显著升高(P<0.05),部分患者(23%)由俯卧位变回仰卧位出现动脉血氧分压下降,无显著意义(P>0.05)。结论:俯卧位通气结合药物治疗和药物治疗均可引起慢性阻塞性肺病患者动脉血氧分压的升高;俯卧位通气结合药物治疗组比药物治疗组动脉血氧分压的升高程度更显著,且升高程度和俯卧时间存在正相关。俯卧位可以提高慢性阻塞性肺病患者动脉血氧分压,且安全性好,经济方便,有利于患者早日康复,值得临床推广应用。

Lay Down a Ventilation in the Application of Copd

Objectivc:Chronic obstructive pulmonary disease patients with different degrees of hypoxemia,prone position ventilation can improve the body’s blood flow increased in proportion to oxygenation capacity.Prone position used in this study,acute exacerbation of chronic obstructive pulmonary disease patients to explore the prone position in patients with chronic obstructive pulmonary disease the relationship between arterial blood oxygen pressure.Methods:Prospective study of patients prone position combined with drug therapy in 42 patients(23 males and 19 females,mean age 62.64 6.34 years),drug treatment 42 patients(20 males and 22 females,mean age 64.10 7.30 years),two patients before treatment,respectively,the eighth day after treatment,measured the level of arterial oxygen pressure,arterial oxygen pressure reflected the changes of the prone position on arterial partial pressure of oxygen.Prone position in patients with drug treatment of 13 volunteers.but also change after the first day back to sit before the prone position,the second,fourth,six days before the 1 hour prone arterial oxygen pressure was measured,reflecting the patients from the prone position changed back to the supine position after the change of arterial oxygen and arterial partial pressure of oxygen change and the relationship between prone time.Results:(1)In the group treated in the prone position(PM),arterial oxygen tension was increased significantly after treatment(P<0.05).(2)In the simple medicine treatment group(SM),oxygenation was also increased significantly after treatment(P<0.05).(3)The improvements of arterial oxygen tension in the two groups were significantly different.The group treated in the prone position has increased arterial oxygen tension more higher(0.0010.05).Conclusion:Ventilation in prone position could improve arterial oxygenation in patients with chronic obstructive pulmonary disease.There were positive relations between the effects of position and the prone time.Prone positioning was safe,economy,easy to operate,it could contribute to patients’ restoring of health,it is worth spreading.