刘婉琳 付敏 夏兰 李林 龙专

    〔摘要〕 目的 觀察改良俯卧位通气在急性呼吸窘迫综合征(acute respiratory distress syndrome， ARDS)患者中的应用效果。方法 选取2018年7月1日至2019年7月1日收治我院呼吸重症监护室接受俯卧位通气治疗的ARDS患者66例，采用随机数字表法分为对照组和观察组各33例，分别采取传统俯卧位通气与改良俯卧位通气，改良俯卧位通气在传统俯卧位通气基础上采用翻身床调整至头高脚低30°，左、右30°倾斜交替进行，每个体位维持2 h，16 h后改为仰卧位。比较两组患者血气指标、血流动力学指标、压力性损伤、胃内容物反流误吸发生率的差异。结果 俯卧位通气16 h后观察组与对照组血气pH值、二氧化碳分压、氧分压、氧合指数、心率、平均动脉压、中心静脉压对比，均无统计学差异(P>0.05);对照组36.36%(12/33)患者发生压力性损伤，其中Ⅰ期9例，Ⅱ期3例;观察组9.09%(3/33)发生了Ⅰ期压力性损伤， 2组患者压力性损伤的发生率和分期比较，差异均有统计学意义(P0.05) after 16 hours of prone ventilation. 36.36% (12/33) of the patients developed pressure injuries were found in the control group， including 9 patients in stage Ⅰand 3 patients in stageⅡ. However， 9.09% (3/33) patients were found in intervention group in stage Ⅰpressure injuries. There were statistical differences in the incidence of pressure injury and stages between the two groups (P0.05) ......