不同侧卧位体位护理在老年泛耐药鲍曼不动杆菌感染重症肺炎患者中的应用效果比较  

Comparison of application effects of different lateral position nursing in elderly patients with severe pneumonia infected by pan-drug resistant Acinetobacter baumannii

作　　者：卢妞 吕鹏鹏 LU Niu;LYU Pengpeng(Respiratory and Critical Care Medicine Department,General Hospital of Pingmei Shenma Group,Pingdingshan 467000,China)

机构地区：[1]平煤神马集团总医院呼吸与危重症医学科,河南平顶山467000

出　　处：《临床医学研究与实践》2023年第5期165-168,共4页Clinical Research and Practice

摘　　要：目的比较左45°-半坐卧位(床头抬高30°)-右45°卧位、左30°-半坐卧位(床头抬高30°)-右30°卧位在老年泛耐药鲍曼不动杆菌(PDR-Ab)感染重症肺炎(SP)患者体位护理中的应用价值。方法选取我院2019年7月至2021年8月收治的94例老年PDR-Ab感染SP患者,根据不同就诊时间将其分为研究组(n=47)和常规组(n=47)。两组均给予常规护理,在此基础上常规组采用左30°-半坐卧位(床头抬高30°)-右30°卧位,研究组采用左45°-半坐卧位(床头抬高30°)-右45°卧位。比较两组的肺功能指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、肺动态顺应性(Cdyn)]、病情相关指标(呼吸频率、心率、氧合指数)、机械通气时间、总住院时间、不同时间的24 h痰液量、预后评分[急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)]、护理满意度。结果干预后,两组的PaO_(2)、Cdyn均升高,PaCO_(2)均降低,且研究组优于常规组(P<0.05)。干预后,两组的呼吸频率、心率均降低,氧合指数均升高,且研究组优于常规组(P<0.05)。研究组的机械通气时间、总住院时间短于常规组(P<0.05)。干预第3、5天,研究组的24 h痰液量少于常规组(P<0.05)。干预后,两组的APACHEⅡ评分均降低,且研究组低于常规组(P<0.05)。研究组的护理满意度高于常规组(P<0.05)。结论左45°-半坐卧位(床头抬高30°)-右45°卧位可提升老年PDR-Ab感染SP患者的肺功能,缓解临床症状,同时有利于改善预后,提升患者的护理满意度。Objective To compare the application value of left 45°-semi-reclining position(bedhead elevation 30°)-right 45°lying position and left 30°-semi-reclining position(bedhead elevation 30°)-right 30°lying position in postural nursing of elderly patients with severe pneumonia(SP)caused by pan-drug resistant Acinetobacter baumannii(PDR-Ab)infection.Methods A total of 94 elderly patients with SP infected by PDR-Ab who were treated in our hospital from July 2019 to August 2021 were selected and divided into study group(n=47)and routine group(n=47)according to different admission time.Both groups were given routine nursing.On this basis,the routine group adopted the left 30°-semi-reclining position(bedhead elevation 30°)-right 30°lying position,and the study group adopted the left 45°-semi-reclining position(bedhead elevation 30°)-right 45°lying position.The pulmonary function indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),pulmonary dynamic compliance(Cdyn)],disease related indexes(respiratory rate,heart rate,oxygenation index),mechanical ventilation time,total hospitalization time,24 h sputum volume at different time,prognosis score[Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)]and nursing satisfaction were compared between the two groups.Results After intervention,PaO_(2) and Cdyn increased,and PaCO_(2) decreased in the two groups,and those in the study group were better than the routine group(P<0.05).After intervention,the respiratory rate and heart rate in the two groups decreased,and the oxygenation index increased,and those in the study group were better than the routine group(P<0.05).The mechanical ventilation time and total hospitalization time in the study group were shorter than those in the routine group(P<0.05).On the 3rd and 5th day of intervention,the 24 h sputum volume in the study group was less than that in the routine group(P<0.05).After intervention,the APACHEⅡscore in the two groups decreased,and that in the study

关 键 词：重症肺炎 体位护理 氧合指数 动脉血氧分压 机械通气 

分 类 号：R473.6[医药卫生—护理学]