俯卧位与翻身时长对烧伤合并急性呼吸窘迫综合征机械通气患者的影响  

Effects of prone positioning and turning duration on burn patients with acute respiratory distress syndrome receiving mechanical ventilation

作　　者：王容容 林静 庄玉娇 董雅萍 苏晓玲 李馨[3] WANG Rongrong;LIN Jing;ZHUANG Yujiao;DONG Yaping;SU Xiaoling;LI Xin(Jinjiang Chendai Central Health Hospital,Quanzhou 362211,China;Joint Logistic Support Force 910 Hospital,Quanzhou 362000,China;Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100730,China)

机构地区：[1]晋江市陈埭中心卫生院,福建省泉州市362211 [2]联勤保障部队第九一〇医院,福建省泉州市362000 [3]首都医科大学附属北京同仁医院口腔科,北京市100730

出　　处：《护理实践与研究》2024年第6期886-891,共6页Nursing Practice and Research

摘　　要：目的 探讨烧伤合并急性呼吸窘迫综合征(ARDS)机械通气患者不同俯卧位与翻身时长对治疗效果的影响。方法 选取2021年6—12月医院烧伤合并ARDS机械通气患者41例作为对照组,采取俯卧位与平卧位均为2 h并交替翻身3次,俯卧位累计6 h;选取2022年1—6月收治的相同疾病患者38例作为观察组,采取俯卧4 h→平卧2 h→俯卧4 h→平卧,俯卧位时间长为8 h。观察对比1周内两组患者的血气分析结果、住院时间、Braden量表评分。结果 更改俯卧位与翻身时长后的第7天,观察组患者的动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))均高于对照组,差异具有统计学意义(P<0.05);观察组患者的动脉血二氧化碳分压(PaCO_(2))低于对照组,差异具有统计学意义(P<0.05);观察组患者住院时间短于对照组,Braden评分高于对照组,差异具有统计学意义(P<0.05)。结论 通过平卧2 h与俯卧4 h交替翻身2次,共俯卧位8 h,可改善患者血气指标,减轻皮肤压力性损伤,缩短住院时间。Objective To explore the effect of different prone positions and turning durations on the therapeutic efficacy in burn patients with acute respiratory distress syndrome(ARDS)receiving mechanical ventilation.Methods The 41 burn patients with ARDS receiving mechanical ventilation in the hospital from June to December 2021 were selected for the control group.They were placed in prone and supine positions for 2 hours each and alternately turned over 3 times,with a total of 6 h in the prone position.Additionally,38 patients with the same conditions admitted from January to June 2022 were selected for the observation group.They were placed in prone position for 4 hours→supine for 2 h→prone for 4 h→supine,totaling 8 h of prone position.The differences in the blood gas analysis results,length of hospital stay,and Braden Scale scores between the two groups were compared within one week.Results On the 7th day after adjusting the prone position and turning duration,the partial pressure of oxygen(PaO_(2))and oxygenation index(PaO_(2)/FiO_(2))of patients in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05);the partial pressure of carbon dioxide in artery(PaCO_(2))of patients in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05);the length of hospital stay of patients in the observation group was shorter than that in the control group,the Braden scores of patients were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Turning over alternately between 2 hours of supine position and 4 hours of prone position twice,totaling 8 hours of prone position,can improve patients'blood gas indexes,alleviate pressure injury of skin,and shorten hospital stay.

关 键 词：烧伤 俯卧位通气 翻身时长 交替翻身 效果 

分 类 号：R473.6[医药卫生—护理学]