摘要
目的探讨动态变化俯卧位机械通气联合护理干预在急性呼吸窘迫综合征(ARDS)中的应用效果。方法选择2018年12月至2020年12月在粤北人民医院就诊的ARDS患者50例,采用随机数字表法分为对照组和观察组,各25例。对照组男19例、女6例,年龄(54.0±30.6)岁;观察组男18例、女7例,年龄(53.8±29.0)岁。对照组采用0°持续俯卧位通气治疗联合护理干预,观察组采用动态变化俯卧位通气治疗(0°俯卧-30°左侧俯卧-45°俯卧位)联合护理干预。比较两组患者的治疗效果。结果两组患者治疗前心率(HR)、中心静脉压(CVP)及平均动脉压(MAP)指标比较差异均无统计学意义(均P>0.05);治疗后,观察组患者的HR、CVP、MAP分别为(73.2±11.2)次/min、(10.5±2.1)mmHg(1 mmHg=0.133 kPa)、(92.9±8.9)mmHg,均优于对照组的(85.1±13.9)次/min、(9.0±1.8)mmHg、(85.5±6.6)mmHg,两组比较差异均有统计学意义(均P<0.05)。观察组治疗后动脉血氧分压(PaO_(2))为(82.0±7.5)mmHg、PaO_(2)/氧浓度分数(FiO_(2))为(131.3±13.7)mmHg,高于对照组的(70.1±7.2)mmHg、(120.6±12.5)mmHg,差异均有统计学意义(均P<0.01)。观察组患者治疗总费用高于对照组[(143451.5±89357.0)元比(111386.3±56345.6)元],死亡病例少于对照组[9例比12例],但差异均无统计学意义(均P>0.05)。观察组的不良反应发生率为20.0%(5/25),低于对照组的52.0%(13/25),两组比较差异有统计学意义(P<0.05)。结论动态变化俯卧位通气治疗联合护理干预可以有效改善ARDS患者的血氧情况,虽然治疗费用较高,但不良反应率及病死率更低。
Objective To investigate the effect of mechanical ventilation in dynamic prone positions combined with nursing intervention for patients with acute respiratory distress syndrome(ARDS).Methods Fifty ARDS patients treated at North Guangdong People's Hospital from December 2018 to December 2020 were selected and divided into a control group and an observation group by the random number table method,with 25 cases in each group.There were 19 males and 6 females in the control group;and they were(54.0±30.6)years old.There were 18 males and 7 females in the observation group;and they were(53.8±29.0)years old.The control group took nursing intervention and mechanical ventilation in 0°prone position,and the observation group in 0°prone position,30°prone position on the left side,and 45°prone position.The treatment effects were compared between these two groups.Results There were no statistical differences in heart rate(HR),central venous pressure(CVP),and mean artery pressure(MAP)before the treatment between these two groups(all P>0.05).After the treatment,the HR,CVP and MAP were(73.2±11.2)times/min,(10.5±2.1)mmHg(1 mmHg=0.133 kPa),and(92.9±8.9)mmHg in the observation group,and were(85.1±13.9)times/min,(9.0±1.8)mmHg,and(85.5±6.6)mmHg in the control group,with statistical differences(all P<0.05).After the treatment,the arterial partial pressure of oxygen(PaO_(2))and PaO_(2)/fraction of inspired oxygen(FiO_(2))were(82.0±7.5)mmHg and(131.3±13.7)mmHg in the observation group,and were(70.1±7.2)mmHg and(120.6±12.5)mmHg in the control group,with statistical differences(both P<0.01).The total treatment cost in the observation group was higher than that in the control group[(143451.5±89357.0)yuan vs.(111386.3±56345.6)yuan;P>0.05].Nine cases died in the observation group and 12 in the control group(P>0.05).The incidence of adverse reactions in the observation group was lower than that in the control group[20.0%(5/25)vs.52.0%(13/25);P<0.05].Conclusions Mechanical ventilation in dynamic prone positions combined with
作者
楚春香
罗健玲
刘惠玲
李金娟
Chu Chunxiang;Luo Jianling;Liu Huiling;Li Jinjuan(North Guangdong People's Hospital,Shaoguan 512026,China)
出处
《国际医药卫生导报》
2021年第15期2384-2387,共4页
International Medicine and Health Guidance News
关键词
动态变化
俯卧位机械通气
护理干预
急性呼吸窘迫综合征
血氧指标
不良反应
Dynamic change
Mechanical ventilation in prone position
Nursing intervention
Acute respiratory distress syndrome
Blood oxygen indicators
Adverse reactions
