两种俯卧位角度对急性呼吸窘迫综合征机械通气患者临床指标的影响  

Effect of two prone position angles on clinical indicators of mechanical ventilation in patients with acute respiratory distress syndrome

作　　者：郭阿茜 王海播 刘富梅 宾永 张红林 GUO Aqian;WANG Haibo;LIU Fumei;BIN Yong;ZHANG Honglin(Henan People's Hospital,Zhengzhou,450000,China)

机构地区：[1]河南省人民医院(郑州大学人民医院)呼吸与危重症医学科,河南省郑州市450000

出　　处：《护理实践与研究》2022年第1期62-65,共4页Nursing Practice and Research

基　　金：河南省医学科技攻关项目(编号:201702193)。

摘　　要：目的比较10°和25°头高足低俯卧位通气角度对急性呼吸窘迫综合征(ARDS)患者氧合指标、血流动力学、压力性损伤发生率、VAP发生率的影响。方法将2020年4月—2021年4月医院收治的ARDS患者,按组间特征具有可比性的原则分为观察组25例和对照组26例。对照组患者给予10°头高足低俯卧位,观察组患者给予25°头高足低俯卧位,观察比较两组俯卧位动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))、血流动力学指标、压力性损伤发生率、VAP的发生情况。结果俯卧位后两组氧合指标、心率等较俯卧位前均有改善,但两指标组间比较差异无统计学意义(P>0.05)。观察组患者压力性损伤发生率及VAP发生率低于对照组,差异有统计学意义(P<0.05)。结论ARDS患者取25°头高足低俯卧位通气既可以有效改善氧合,也可以降低患者压力性损伤及VAP发生率,是ARDS患者行机械通气时较合适的体位。Objective To compare the effects of ventilation of 10°and 25°high head low foot prone position on oxygenation index,hemodynamics,incidence of stress injury and VAP on patients with acute respiratory distress syndrome(ARDS).Methods ARDS patients admitted in the hospital from April 2020 to April 2021 were selected and divided into observation group(n=25)and control group(n=26)according to the principle of characteristics comparability between groups.The control group was given 10°high head low foot prone position,the observation group was given 25°high head low foot prone position.The two groups were observed and compared in the prone position,arterial partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),oxygenation index(PaO2/FiO2),hemodynamic indexes,the incidence of pressure injury and the occurrence of VAP.Results After prone position,oxygenation index and heart rate were improved,but there was no statistically significant between two groups(P>0.05).The incidence of stress injury and VAP in observation group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion Patients took the 25°high head low feet prone position could not only improve oxygenation,but also reduce the incidence of stress injury and VAP in patients with ARDS,which was a suitable position for mechanical ventilation in patients with ARDS.

关 键 词：急性呼吸窘迫综合征 机械通气 俯卧位 氧合指数 压力性损伤 VAP 

分 类 号：R473.5[医药卫生—护理学]