多学科联合保护性管理策略与高侧卧位通气改善重症肺炎机械通气患者预后的临床研究  

Effect of multidisciplinary joint protective management strategy combined with high lateral recumbent ventilation in improving the prognosis of mechanically ventilated patients with severe pneumonia

作　　者：刘茳 徐伟华[1] 刘杨 许翠娟 刘静 李红[1] LIU Jiang;XU Weihua;LIU Yang(Department of Critical Care Medicine,the People’s Hospital of Langfang City,Hebei,Langfang 065000,China)

机构地区：[1]河北省廊坊市人民医院重症医学科,065000

出　　处：《河北医药》2024年第7期1045-1048,共4页Hebei Medical Journal

基　　金：河北省廊坊市科技支撑计划项目(编号:2023013061)。

摘　　要：目的研究多学科联合保护性管理策略与高侧卧位通气改善重症肺炎机械通气患者预后的临床效果。方法将廊坊市人民医院重症医学科2021年5月至2023年7月收治的82例重症肺炎机械通气患者按随机数字表法分为对照组和研究组,每组41例。对照组采用常规机械通气,研究组采用多学科联合保护性管理策略联合高侧卧位通气,比较2组患者的氧合指数、血气分析指标、机械通气时间及住院时间、肺功能指标及心理状况。结果干预前2组患者氧合指数、血气分析指标、肺功能指标及心理状况比较,差异无统计学意义(P>0.05);干预后研究组患者氧合指数、血氧分压(PaO_(2))、最大呼气峰流速(PEF)、最大呼气中期流量(MMF)及FEV1/FVC(第1秒用力呼气容积/用力肺活量)高于对照组,差异有统计学意义(P<0.05);干预后研究组患者动脉血二氧化碳分压(PaCO_(2))、SAS、SDS评分低于对照组,差异有统计学意义(P<0.05);干预后研究组患者机械通气时间、住院时间短于对照组,差异有统计学意义(P<0.05)。结论多学科联合保护性管理策略联合高侧卧位通气能够有效改善重症肺炎患者的氧合指数、血气分析指标及心理状况,同时提高患者的肺功能,缩短患者的机械通气时间及住院时间,综合改善患者预后,值得临床推广。Objective To study the clinical effect of multidisciplinary joint protective management strategy and high lateral recumbent ventilation in improving the prognosis of mechanically ventilated patients with severe pneumonia.Methods A total of 82 mechanically ventilated patients with severe pneumonia admitted to the Department of Critical Care Medicine at Langfang People’s Hospital from May 2021 to July 2023 were randomly divided into a control group(n=41)and a study group(n=41).Patients in the control group received conventional mechanical ventilation,while patients in the study group received multidisciplinary protective management strategy combined with high lateral recumbent ventilation.The oxygenation index,blood gas analysis indicators,mechanical ventilation time,and hospitalization,lung function indicators and psychological status of patients between groups were compared.Results There was no statistically significant difference in oxygenation index,blood gas analysis indicators,lung function indicators,and psychological status between the two groups of patients before intervention(P>0.05).After intervention,the oxygenation index,partial pressure of blood oxygen(PaO_(2)),peak expiratory flow rate(PEF),maximum mid-expiratory flow(MMEF),and(forced expiratory volume/forced vital capacity in the first second(FEV1/FVC))of patients in the study group were significantly higher than those in the control group(P<0.05).After intervention,the arterial blood partial pressure of carbon dioxide(PaCO_(2)),Self-Rating Anxiety/Depression Scale(SAS/SDS)scores of the study group were significantly lower than those of the control group(P<0.05).After intervention,the mechanical ventilation time and hospitalization of patients in the study group were significantly shorter than those of the control group(P<0.05).Conclusion The combination of multidisciplinary protective management strategies and high lateral recumbent ventilation can effectively improve the oxygenation index,blood gas analysis indicators,and psychological status of

关 键 词：重症肺炎 机械通气 多学科联合保护性管理策略 高侧卧位通气 

分 类 号：R563.1[医药卫生—呼吸系统]