两种体位对呼吸机相关性肺炎的影响

Effect of Different Body Position on Ventilator-Associated Pneumonia

目的探讨ICU机械通气患者取半坐卧位、平卧位与呼吸机相关性肺炎(VAP)的关系。方法将112例机械通气患者随机分为平卧位组和半坐卧位组各56例,观察两组通气后1h、24h、48h、72h的动脉血气分析、痰培养及VAP发生率。结果半坐卧位组VAP发生率明显低于平卧位组(P<0.05),PaO2和PaO2/FiO2明显高于平卧位组(P<0.05;P<0.01)。结论机械通气患者取半坐卧位可有效降低VAP发生率,提高呼吸通气疗效。

Objective To study the relationship between the body position （supine position and semi-supine position） and ventilator-associated pneumonia（VAP） in ICU. Methods 112 patients undergoing mechanical ventilation were randomly divided into supine position group （ n = 56 ） and semi-supine position group （ n = 56 ） , arterial blood gas analysis, sputum culture and occurrence of VAP in 1 hour,24 hours ,48 hours and 72 hours were respectively observed after the application of mechanical ventilation. Results The occurrence of VAP was apparently lower in the semi-supine position group than that in the supine position group （P 〈 0.01 ）. PaO2 and PaO2/FiO2 were evidently higher in the semi-supine position group than that in the supine position group （ P 〈 0. 05 ; P 〈 0. 01 ）. Conclusion Taking semi-supine position when giving patients mechanical ventilation can effectively reduce the incidences of VAP and increase the effectiveness of ventilation.