摘要
目的观察俯卧位通气联合镇痛排痰治疗吸入性损伤并发急性呼吸窘迫综合征(ARDS)的效果。方法选取2018年2月~2020年2月我院接诊的64例吸入性损伤并发ARDS患者为研究对象,采用随机数字表法分为对照组和观察组,各32例。对照组采用俯卧位通气治疗,观察组在对照组基础上行予振动排痰治疗,比较两组呼吸动力学指标[心率(HR)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉压(MAP)、血氧饱和度(SaO2)、氧合指数(OI)、气道峰压(PIP)、气道阻力(Raw)]血流动力学指标[中心静脉压(CVP)、血管通透性指数(PVPI)、血管外肺水指数(EVLWI)]、舒适度评分及并发症发生情况。结果治疗后观察组HR、PaCO2、PIP、Raw均低于对照组,PaO2、MAP、SaO2、OI均高于对照组,差异有统计学意义(P<0.05);治疗后观察组CVP高于对照组,PVPI、EVLW均低于对照组,差异有统计学意义(P<0.05);治疗后观察组舒适度评分均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为15.62%,低于对照组的28.12%,差异有统计学意义(P<0.05)。结论俯卧位通气联合振动排痰可促进呼吸功能和血流动力学改善,增加排痰量,减轻患者痛苦,提高其舒适度,降低并发症发生率。
Objective To observe the effect of prone position ventilation combined with analgesia and expectoration in the treatment of inhalation injury complicated by acute respiratory distress syndrome(ARDS).Methods 64 patients with inhalation injury complicated by ARDS who were admitted to our hospital from February 2018 to February 2020 were selected as the research objects.They were divided into control group and observation group by random number table method,with 32 cases in each group.The control group was treated with prone position ventilation,and the observation group was treated with vibration expectoration on the basis of the control group.The respiratory dynamics indexes of the two groups were compared[heart rate(HR),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial pressure(MAP),blood oxygen saturation(SaO2),oxygenation index(OI),peak airway pressure(PIP),airway resistance(Raw)]hemodynamic indicators[central venous pressure(CVP),Vascular Permeability Index(PVPI),Extravascular Lung Water Index(EVLWI)],comfort score,and complications.Results After treatment,HR,PaCO2,PIP and Raw of the observation group were lower than those of the control group,PaO2,MAP,SaO2,and OI were all higher than those of the control group,the difference was statistically significant(P<0.05);CVP of the observation group was higher than the control group after treatment,PVPI and EVLW were lower than the control group,the difference was statistically significant(P<0.05);the comfort scores of the observation group were higher than the control group after treatment,the difference was statistically significant(P<0.05);the incidence of complications in the observation group was 15.62%,which was lower than 28.12%in the control group,the difference was statistically significant(P<0.05).Conclusion Prone position ventilation combined with vibration sputum excretion can improve respiratory function and hemodynamics,increase sputum excretion,relieve patients'pain,improve their comfort,and reduce the incidence of complications.
作者
戴小华
简桂女
喻华妹
王永美
邱翔
DAI Xiao-hua;JIAN Gui-nv;YU Hua-mei;WANG Yong-mei;QIU Xiang(Department of Burns,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China)
出处
《医学信息》
2021年第1期182-184,共3页
Journal of Medical Information
基金
江西省卫生健康委科技计划(编号:20192000)。
关键词
俯卧位通气
振动排痰
吸入性损伤
ARDS
Prone position ventilation
Vibration expectoration
Inhalation injury
ARDS
