仰俯卧位机械通气对重症肺炎合并呼吸衰竭患者肺功能及炎症因子水平的影响

doi:10.3969/j.issn.1671-7171.2023.09.010

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Abstract 【Objective】To investigate the effects of prone and supine mechanical ventilation on pulmonary function and levels of inflammatory cytokines in patients with severe pneumonia complicated by respiratory failure.【Methods】Eighty patients with severe pneumonia complicated by respiratory failure treated in our hospital from January 2020 to January 2022 were selected. They were randomly divided into the observation group and the control group,with 40 cases in each group. Patients in the observation group received mechanical ventilation in the prone position,while the control group was ventilated in the standard supine position. Clinical efficacy,adverse event rates,and pulmonary function parameters [Forced Expiratory Volume in 1 second (FEV₁),Peak Expiratory Flow (PEF),ratio of FEV₁ to Forced Vital Capacity (FEV₁/FVC),and Dynamic Lung Compliance (Cdyn)],levels of inflammatory cytokines [Soluble Triggering Receptor Expressed on Myeloid cells-1 (sTREM-1),High Sensitivity C-reactive Protein (hs-CRP),Interleukin-6 (IL-6)],and blood gas indicators [Oxygen Saturation (SpO₂),Arterial Oxygen Partial Pressure (PaO₂),and Carbon Dioxide Partial Pressure (PaCO₂)] were compared between the two groups.【Results】The overall effectiveness in the observation group was significantly higher than that in the control group (P<0.05). Post-treatment FEV₁,PEF,FEV₁/FVC,and Cdyn in both groups were higher than those before treatment (P<0.05),with FEV₁,PEF,FEV₁/FVC,and Cdyn in the observation group being significantly higher than those the control group (P<0.05). Post-treatment sTREM-1,hs-CRP,and IL-6 in both groups were lower than those before treatment (P<0.05),and sTREM-1,hs-CRP,and IL-6 in the observation group were significantly lower than those in the control group (P<0.05). After treatment,PaO₂ and SpO₂ in both groups were higher than before treatment,and PaCO₂ was lower than before treatment (P<0.05); And the PaO₂ and SpO₂ in the observation group showed higher than those in the control group,while PaCO₂ showed lower than those in the control group (P<0.05). The incidence of adverse events between the two groups were not significantly different (P>0.05).【Conclusion】Prone position mechanical ventilation offers better treatment efficacy for patients with severe pneumonia and respiratory failure in comparison to the supine ventilation,through favorably improving pulmonary function,modulating inflammatory cytokine levels,and blood gas indicators. It also demonstrates good safety,thus recommended for clinical application.

Key words： Pneumonia/CO Respiratory Insufficiency/CO Respiration,Artificial Inflammation Mediators

Received: 25 November 2022

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R563.1

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2023.09.010 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2023/V40/I9/1315

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