摘要
目的探讨俯卧位通气、支气管肺泡灌洗以及两者联合治疗对重症肺炎(SP)机械通气患者的病情影响。方法采用前瞻性试验对照研究方法,将2020年6月至2022年1月川北医学院附属医院急诊ICU及川北医学院附属三台医院重症医学科收治的符合纳入标准的96例SP机械通气患者用随机数表法分为常规治疗组、俯卧位通气组、支气管肺泡灌洗组、联合治疗组,每组各24例,各组在常规肺炎治疗的基础上,采用上述不同的干预措施,观察治疗前及治疗后的病情指标以及住ICU时间。结果四组患者治疗后3、7 d的急性生理与慢性健康(APACHEⅡ)评分、简易临床肺部感染(CPIS)评分均显著降低,且联合治疗组降低程度显著优于俯卧位通气组、支气管肺泡灌洗组和常规治疗组,差异有统计学意义(P<0.05);四组患者平均住ICU时间比较,差异有统计学意义(P<0.05)。结论俯卧位通气、支气管肺泡灌洗以及两者联合均可改善SP机械通气患者病情严重程度,降低APACHEⅡ、简易CPIS评分,其中联合治疗组效果更佳;俯卧位通气、支气管肺泡灌洗以及两者联合均可缩短患者住ICU时间,其中联合治疗组住ICU时间最短。
Objective To investigate the effects of prone position ventilation,bronchoalveolar lavage,and their combination therapy on the condition of patients with severe pneumonia(SP)undergoing mechanical ventilation.Methods A prospective experimental controlled study was used.96 patients with mechanical ventilation of SP who met the inclusion criteria and were admitted to the Emergency ICU of the Affiliated Hospital of North Sichuan Medical College and the Intensive Care Unit of the Santai Hospital Affiliated to North Sichuan Medical College from June 2020 to January 2022 were divided into a conventional treatment group,a prone position ventilation group,a bronchoalveolar lavage group,and a combination treatment group using a random number table method,with 24 cases in each group.Each group received different intervention measures based on conventional pneumonia treatment.The condition indicators before and after treatment and the duration of stay in the ICU were investigated.Results The acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores and clinical pulmonary infection score(CPIS)of the four groups of patients were significantly reduced 3 and 7 days after treatment,and the combined treatment group showed a statistically significant decrease compared to the prone position ventilation group,bronchoalveolar lavage group,and conventional treatment group(P<0.05);The differences in average ICU stay among the four groups of patients were statistically significant(P<0.05).Conclusion Prone position ventilation,bronchoalveolar lavage,and their combination can improve the severity of patients with severe pneumonia under mechanical ventilation,reduce APACHEⅡ,and simplify CPIS scores,and the conventional treatment group have the best effect.Prone position ventilation,bronchoalveolar lavage,and a combination of both could shorten the patient’s stay in the ICU,and the conventional treatment group have the shortest stay in the ICU.
作者
王家珍
黄钲
钟医航
唐兴霞
曹小平
邹健金
WANG Jiazhen;HUANG Zheng;ZHONG Yihang;TANG Xingxia;CAO Xiaoping;ZOU Jianjin(Intensive Care Unit,Affiliated Santai Hospital of North Sichuan Medical College,Sichuan,Santai 621100,China;Department of Emergency Medicine,West China Hospital of Sichuan University,Sichuan,Chengdu 610041,China;Department of Emergency Medicine,Affiliated Hospital of North Sichuan Medical College,Sichuan,Nanchong 637300,China)
出处
《中国医药科学》
2023年第14期11-15,共5页
China Medicine And Pharmacy
基金
“十三五”国家重点研发计划(2019YFF0216500)。
关键词
重症肺炎
俯卧位通气
支气管肺泡灌洗
机械通气
Severe pneumonia
Prone position ventilation
Bronchoalveolar lavage
Mechanical ventilation
