摘要
目的：探讨侧俯卧位通气改善机械通气患儿血氧饱和度、降低呼吸机相关性肺炎（ VAP）发生率的效果。方法采用随机对照试验法，将265例机械通气患儿按照随机数字表法分为观察组132例与对照组133例，观察组采取侧俯卧位左侧卧位右侧卧位交替翻身方法（每2小时翻身一次），对照组采用传统的仰卧位左侧卧位右侧卧位交替方法。观察两组患儿VAP的发生率、机械通气时间、ICU住院时间、总住院时间、病死率与观察组患儿俯卧位前后pH值、血气分析各项指标。结果观察组VAP发生率为16．7％，对照组为30．8％，差异有统计学意义（χ2＝7．330，P＝0．007）；观察组病死率为6．1％，对照组为19．5％，差异有统计学意义（χ2＝10．777，P＝0．001）。观察组机械通气时间、ICU住院时间和总住院时间分别为（7．55±1．87），（13．57±1．87），（16．98±1．92） d，对照组依次为（13．20±4．10），（19．19±4．12），（23．05±4．42）d，差异均有统计学意义（t值分别为14．406，14．293，14．459；P＜0．01）。观察组患儿俯卧位前后pH值、血气分析各项指标如PaCO2、PaO2、与SpO2均较俯卧位前改善，差异有统计学意义（t值分别为3．937，12．673，17．664，13．816；P＜0．05）。结论俯卧位可有效改善机械通气患儿血氧饱和度，降低VAP发生率和死亡风险，进而减少机械通气时间和住院时间。
Objective To examine the effect of lateral prone position on oxygenation and ventilator associated pneumonia （ VAP） .Methods Totals of 265 patients were randomly divided into the observation group （ n=132） and the control group （ n=133） .The observation group received lateral prone-left lateral-right lateral position, and the control group received supine-left lateral-right lateral position.The incidence of VAP, the duration of mechanical ventilation, the ICU stays and hospital stays were recorded.pH and arterial blood gas were prepared between the two groups.Results The incidence rates of VAP in the observation group and the control were 16.7% and 30.8%.There was a significant difference （χ2 =7.330,P=0.007）.The mortality of the observation group and the control were 6.1%and 19.5%.There was a significant difference （χ2 =10.777,P=0.001）.The duration of mechanical ventilation, ICU stays and hospital stays were （7.55 ±1.87）, （13.57 ± 1.87） and （16.98 ±1.92） days in the observation group, and （13.20 ±4.10）, （19.19 ±4.12）, （23.05 ± 4.42） days in the control group.There were significant differences （ t=14.406, 14.293, 14.459, respectively;P〈0.01）.pH, arterial blood gas, such as PaCO2, PaO2, SpO2 were significantly improved than before in the observation group （t=3.937, 12.673, 17.664, 13.816, respectively;P〈0.05）.Conclusions Lateral prone position can effectively improve the oxygenation, reduce the incidence of VAP, and reduce the duration of mechanical ventilation and hospital stays.
出处
《中华现代护理杂志》
2014年第33期4255-4257,共3页
Chinese Journal of Modern Nursing
关键词
儿童
肺炎
呼吸机相关性
侧俯卧位
Children
Pneumonia,ventilator-associated
Prone position
