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目的研究对合并患有重症胰腺炎及急性呼吸窘迫综合征氧合的患者在机械通气时采用短时侧俯卧位的临床效果。方法选取近年收治的ARDS并发重症胰腺炎患者,均采用机械通气治疗。将患者随机分为对照组及观察组,对照组为常规治疗,观察组为侧俯卧位治疗。对比两组患者呼吸机上机时间、血气指标变化情况以及心率及平均动脉压差异。结果上机时间方面,观察组在40min左右,对照组在1h左右,对比差异显著(P<0.05)。血气指标方面,通气半小时时组间无明显差异(P>0.05),从一小时开始,观察组Sp O2、Pa O2、Pa O2/Fi O2三项检测值明显高于对照组(P<0.05),并随着时间的增长差距逐渐拉大;但Pa CO2对比始终无明显变化(P>0.05)。心率及平均动脉压方面,组间对比差异不明显(P>0.05)。结论对重症胰腺炎并发ARDS患者在机械通气时取侧俯卧位可缩短上机时间,更好的改善氧合状态,具有临床推广价值。
Objective To study the clinical effect of short-term prone position in mechanical ventilation in patients with severe pancreatitis and acute respiratory distress syndrome combined with oxygenation. Methods In recent years, patients with severe acute pancreatitis admitted to ARDS were treated with mechanical ventilation. The patients were randomly divided into control group and observation group, the control group was routine treatment, the observation group was lateral prone position treatment. Comparing the two groups of patients with ventilator machine time, blood gas changes in heart rate and heart rate and mean arterial pressure differences. Results On the machine time, the observation group at about 40min, the control group at about 1h, the difference was significant (P <0.05). There were no significant differences in blood gas indexes between the two groups (P> 0.05). After one hour, the values of Sp O2, Pa O2 and Pa O2 / Fi O2 in the observation group were significantly higher than those in the control group (P <0.05 ), And the gap gradually widened with time; however, Pa CO2 contrast had no significant change (P> 0.05). Heart rate and mean arterial pressure, the difference between groups was not significant (P> 0.05). Conclusion Severe pancreatitis complicated with ARDS patients taking side prone position during mechanical ventilation can shorten the time on the machine and better improve the oxygenation status, which has the clinical popularization value.