无创机械通气患儿不同卧位干预的效果  

Effect of different positioning schemes for children on non-invasive mechanical ventilation

作　　者：刁海燕[1] 赵雪琴[1] 

机构地区：[1]江苏省苏北人民医院儿科,江苏扬州225001

出　　处：《护理学杂志》2015年第19期32-34,共3页

摘　　要：目的探讨卧位干预对无创机械通气患儿血氧饱和度及呼吸机相关性肺炎(VAP)发生情况的影响。方法选取103例机械通气患儿,按照入院时间顺序分为研究组51例与对照组52例,机械通气过程中,研究组给予侧俯卧位-左侧卧位-右侧卧位交替翻身方法,对照组给予传统的仰卧位-左侧卧位-右侧卧位交替翻身方法。比较两组血气分析各项指标[pH值、动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、血气饱和度(SpO2)变化)],及VAP发生率的变化。结果研究组机械通气、吸氧及住院时间显著短于对照组(均P<0.01),其VAP发生率及病死率低于对照组,但差异无统计学意义(均P>0.05)。研究组PaO2、PaCO2及SpO2均较治疗前显著改善,并且显著优于对照组(P<0.05,P<0.01)。结论有效的卧位干预能有效改善机械通气患儿血氧饱和度,改善患儿预后。Objective To evaluate the effects of different positioning schemes on oxygen saturation and incidence rate of ventilator as- sociate pneumonia（VAP） in children on nominvasive mechanical ventilation. Methods A total of 103 children on non invasive me- chanical ventilation were were divided into a control group （n= 52） and an observation group （n= 51） according to their hospitali zation dates. During non-invasive mechanical ventilation , the observation group were subjected to a modified positioning scheme of alternating from lateral prone,left lateral,to right lateral position, while the controls were assigned to a traditional scheme of alter nating from supine, left lateral,to right lateral position. The incidence rates of VAP and arterial blood gas results（pH, PaO2, PaCO2 ,SpO2 ） were compared between the two groups. Results The average lengths of non-invasive mechanical ventilation, oxygen inhalation ,and hospital stay in the observation group were significantly shorter than those in the control group（P〈0.01 for all） the incidence rate of VAP and mortality rate in the observation group were lower than those of the control group, without signifi cant differences （P〉0.05 for both）. Arterial blood gas results of PaO2 ,PaCO2 and SpOz in the observation group were better than before the intervention, and also better than those of the control group （P〈 0. 05, P〈 0. 01）. Conclusion Effective positioning scheme during non-invasive mechanical ventilation could improve oxygenation of children, therefore better their prognosis.

关 键 词：无创机械通气 卧位干预 呼吸机相关性肺炎 侧俯卧位 血氧饱和度 

分 类 号：R473.72[医药卫生—护理学]