摘要
目的探究不同卧位方式在慢性阻塞性肺疾病急性加重期(AECOPD)通气治疗中的应用。方法选取2017年7月至2020年6月在江苏省南通市第三人民医院接受机械通气治疗的102例AECOPD患者。采用随机数字表法将患者分为对照组和观察组,每组各51例。两组均实施常规机械通气护理,对照组采用常规的仰卧位干预,观察组实施俯卧位通气体位干预。观察并比较干预前、干预72 h后两组氧合指数(PaO_(2)/FiO_(2))与pH值、呼气末正压通气(PEEP)、与动态肺顺应性(Cdyn)及病情恢复程度之间的差异性。结果干预72 h后,两组PEEP、Cdyn高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。干预72 h后,观察组PaO_(2)/FiO_(2)、pH值高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。干预72 h后,观察组急慢性生理-病理健康状况评分低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论俯卧位机械通气治疗可改善氧合指数及血气分析值,肺部顺应性明显好转,降低患者病情危重程度。
Objective To explore the application of different supine positions in the ventilation treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 102 AECOPD patients who received mechanical ventilation in Nantong Third People’s Hospital of Jiangsu Province from July 2017 to June 2020 were selected.The patients were divided into control group and observation group by random number table method,with 51 cases in each group.Both groups were given routine mechanical ventilation nursing,while the control group was given conventional supine position intervention,and the observation group was given prone position ventilation position intervention.The differences between the two groups of oxygenation index(PaO_(2)/FiO_(2)),pH value,positive end-expiratory pressure(PEEP),dynamic lung compliance(Cdyn),and the degree of recovery were observed and compared before and after the intervention for 72 h.Results After 72 h of intervention,the PEEP and Cdyn of the two groups were higher than those before the intervention,while those of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After 72 h of intervention,the PaO_(2)/FiO_(2) and pH values of the observation group were higher than those before the intervention,while those of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After 72 h of intervention,the acute physiology and chronic health evaluation score system score of the observation group was lower than that before the intervention,while the observation group was lower than the control group,and the differences were statistically significant(P<0.05).Conclusion Mechanical ventilation in prone position can improve oxygenation index and blood gas analysis value,significantly improve lung compliance,and reduce the severity of the patient’s condition.
作者
杜凤燕
张云
王东丽
陆玉梅
DU Fengyan;ZHANG Yun;WANG Dongli;LU Yumei(Department of Critical Care Medicine,Nantong Third People’s Hospital,Jiangsu Province,Nantong 226006,China)
出处
《中国医药导报》
CAS
2022年第29期157-160,共4页
China Medical Herald
基金
江苏省卫生健康委科研课题项目(H2019109)。
关键词
俯卧位机械通气治疗
慢性阻塞性肺疾病
急性加重期
急性生理和慢性健康状况评分Ⅱ
Mechanical ventilation treatment in the prone position
Chronic obstructive pulmonary disease
Acute phase onset
Acute physiology and chronic health evaluation-Ⅱscore
