摘要
目的:观察床头抬高30°对重症颅脑损伤(STBI)术后机械通气患者的影响。方法:选取78例STBI术后机械通气患者为研究对象,按照随机数字表法分为对照组(n=38)和观察组(n=40)。对照组术后采用床头抬高45°,观察组术后采用床头抬高30°,比较两组不同时间颅内压水平、脑灌注压水平,呼吸机相关肺炎(VAP)发生率、压疮发生率及护理满意度。结果:术后24、48、72 h,观察组颅内压水平均低于对照组,脑灌注压水平均高于对照组,差异有统计学意义(P<0.05);观察组压疮发生率为2.50%,低于对照组的21.05%,差异有统计学意义(P<0.05);两组VAP发生率比较,差异无统计学意义(P>0.05);观察组护理满意度为92.50%,高于对照组的76.32%,差异有统计学意义(P<0.05)。结论:床头抬高30°应用于STBI术后机械通气患者,可降低颅内压,提高脑灌注压,降低压疮发生率,提高护理满意度,且不增加VAP发生风险,其效果优于床头抬高45°。
Objective:To observe effects of bed head 30°elevation on mechanical ventilation patients after severe traumatic brain injuries(STBI).Methods:78 patients with mechanical ventilation after STBI were selected as the research objects,and were divided into control group(n=38)and observation group(n=40)according to the random number table method.In the control group,the bed head was elevated by 45°after the surgery,while in the observation group,the bed head was elevated by 30°after the surgery.The intracranial pressure levels,the cerebral perfusion pressure levels,the incidence of ventilator-associated pneumonia(VAP),the incidence of pressure ulcers and the nursing satisfaction were compared between the two groups at different times.Results:24 h,48 h and 72 h after the surgery,the intracranial pressure levels in the observation group were lower than that in the control group;the cerebral perfusion pressure levels were higher than those in the control group;and the differences were statistically significant(P<0.05).The incidence of pressure ulcers in the observation group was 2.50%,which was lower than 21.05%in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the incidence of VAP between the two groups(P>0.05).The nursing satisfaction of the observation group was 92.50%,which was higher than the control group of 76.32%,and the difference was statistically significant(P<0.05).Conclusions:The bed head 30°elevation for the patients with mechanical ventilation after STBI can reduce the intracranial pressure,increase the cerebral perfusion pressure,reduce the incidence of pressure ulcers and improve nursing satisfaction without increasing the risk of VAP,.Moreover,it is superior to the bed head 45°elevation.
作者
李美真
王有勤
蔡梦航
LI Meizhen;WANG Youqin;CAI Menghang(The Second Affiliated Hospital of Luohe Medical College,Department of Critical Care Medicine,Luohe 462300 Henan,China;The Second Affiliated Hospital of Luohe Medical College,Department of Neurology,Luohe 462300 Henan,China)
出处
《中国民康医学》
2022年第10期173-175,共3页
Medical Journal of Chinese People’s Health
关键词
床头抬高30°
重症颅脑损伤
机械通气
呼吸机相关肺炎
颅内压
压疮
Bed head 30°elevation
Severe traumatic brain injury
Mechanical ventilation
Ventilator-associated pneumonia
Intracranial pressure
Pressure ulcer
