不同床头抬高角度在ICU机械通气患者中的应用效果  

Effect of Different Bed Head Elevation Angles in ICU Patients with Mechanical Ventilation

作　　者：韦玉秀 韦树旺[1] 谢玲玲[1] 黄洪斌[1] 兰婕燕 韦张旭 WEI Yu-xiu;WEI Shu-wang;XIE Ling-ling;HUANG Hong-bin;LAN Jie-yan;WEI Zhang-xu(The Third People's Hospital of Hechi City,Guangxi Hechi 547000)

机构地区：[1]河池市第三人民医院,广西河池547000

出　　处：《深圳中西医结合杂志》2022年第7期118-121,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探讨不同床头抬高角度在重症监护病房(ICU)机械通气患者中的应用及效果。方法:选取2015年1月至2019年12月河池市第三人民医院ICU收治的200例患者为研究对象,按随机数字表法分为对照组和观察组,每组100例。观察组持续抬高床头20°~25°,鼻饲及鼻饲后2 h床头抬高30°~45°;对照组持续床头抬高30°~45°。比较两组患者误吸、呼吸机相关性肺炎(VAP)、压疮发生率;监测两组患者动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))变化。结果:观察组患者误吸、VAP发生率与对照组比较,差异无统计学意义(P>0.05)。观察组患者压疮发生率显著低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗前后PaO_(2)、PaCO_(2)水平比较,差异无统计学意义(P>0.05)。结论:对ICU机械通气患者持续抬高床头20°~25°能有效预防压疮,且不增加VAP发生风险,是较为理想的体位。Objective To investigate the application and effect of different bedside elevation angles in patients with mechanical ventilation in ICU.Methods A total of 200 patients admitted to ICU of the Third People's Hospital of Hechi City from January 2015 to December 2019 were selected as the research objects,and they were divided into a control group and an observation group according to random number table method,with 100 patients in each group.In the observation group,the head of the bed was continuously raised 20°~25°,and the head of the bed was raised 30°~45°after nasogastric feeding and 2 h after nasogastric feeding.The control group continued to elevate the head of the bed by 30°~45°.The incidence of aspiration,ventilator-associated pneumonia(VAP)and pressure ulcers were compared between the two groups.Arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))were monitored.Results There was no significant difference in the incidence of wrong inhalation and VAP between the observation group and control group(P>0.05).The incidence of pressure ulcers in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in PaO_(2) and PaCO_(2) levels between the two groups before and after treatment(P>0.05).Conclusion For patients with mechanical ventilation in ICU,raising the head of bed continuously at 20°~25°can effectively prevent pressure ulcers and does not increase the risk of VAP,so it is an ideal position.

关 键 词：机械通气 重症监护病房 床头抬高角度 呼吸机相关性肺炎 压疮 

分 类 号：R563.1[医药卫生—呼吸系统]