俯卧位机械通气对重症肺炎合并呼吸衰竭患者血气分析指标及疾病好转情况的影响  

The effect of prone position mechanical ventilation on blood gas analysis indicators and disease improvement in patients with severe pneumonia complicated with respiratory failure

作　　者：王方[1] 李丽[1] 姜相东 WANG Fang;LI Li;JIANG Xiangdong(Department of Critical Care Medicine,the 967th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Dalian,Liaoning,116000,China)

机构地区：[1]中国人民解放军联勤保障部队第九六七医院重症医学科,辽宁大连116000

出　　处：《当代医学》2024年第5期54-58,共5页Contemporary Medicine

摘　　要：目的探究俯卧位机械通气对重症肺炎合并呼吸衰竭患者血气分析指标及疾病好转情况的影响。方法选取2018年6月至2021年6月中国人民解放军联勤保障部队第九六七医院接诊的82例重症肺炎合并呼吸衰竭患者作为研究对象,按照随机抽签法分为对照组与观察组,每组41例。两组均行常规对症治疗,对照组辅以仰卧位机械通气,观察组辅以俯卧位机械通气。比较两组疾病好转率、干预前后血气指标、机械通气时间及住院时间、并发症发生情况及干预前后急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分。结果干预7 d后,观察组疾病好转率高于对照组,差异有统计学意义(P<0.05)。干预7 d后,两组血液pH、血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))水平均高于干预前,动脉血二氧化碳分压(PaCO_(2))均低于干预前,且观察组血液pH、SaO_(2)、PaO_(2)高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。观察组机械通气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。干预7 d后,两组APACHE-Ⅱ评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论俯卧位机械通气可提高重症肺炎呼吸衰竭患者疾病好转率,减轻病情严重程度,改善血气指标,缩短机械通气时间、住院时间,使其早日康复出院。Objective To explore the effect of prone positon mechanical ventilation on blood gas analysis indicators and disease improvement in patients with severe pneumonia complicated with respiratory failure.Methods 82 patients with severe pneumonia complicated with respiratory failure who were treated at the 967th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from June 2018 to June 2021 were selected as the study subjects,and they were randomly divided into the control group and the observation group,with 41 cases in each group.Both groups received routine symptomatic treatment,with the control group was supplemented supine position mechanical ventilation and the observation group was supplemented prone position mechanical ventilation.The disease improvement rate,blood gas indicators before and after intervention,mechanical ventilation time and hospitalization time,incidence of complications,and acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores before and after intervention were compared between two groups.Results After 7 d of intervention,the disease improvement rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After 7 d of intervention,the levels of blood pH,arterial oxygen saturation(SaO_(2)),and partial pressure of arterial oxygen(PaO_(2))of the two groups were higher than before intervention,the partial pressure of carbon dioxide in arterial blood(PaCO_(2))was lower than before intervention,and the pH,SaO_(2) and PaO_(2) in the observation group were higher than those in the control group,PaCO_(2) was lower than that in the control group,the differences were statistically significant(P<0.05).The mechanical ventilation time and hospitalization times in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups.A

关 键 词：重症肺炎合并呼吸衰竭 俯卧位 机械通气 血气分析 疾病好转情况 

分 类 号：R563.8[医药卫生—呼吸系统]