俯卧位不同翻身时间对急性呼吸窘迫综合征机械通气患者的影响

Study on the time of position change in acute respiratory distress syndrome patients treated with prone position mechanical ventilation

目的探讨急性呼吸窘迫综合征(ARDS)机械通气患者俯卧位不同时间翻身出现的护理并发症、患者舒适性及治疗效果。方法将76例ARDS机械通气患者按入院序号分为两组,两组患者每天均采取俯卧位通气6h,其中单号为观察组38例,采取俯卧位3h后平卧位2h,卧位翻身次数为2次,其余时间为平卧或侧卧位通气;双号为对照组38例,采取俯卧位2h后平卧位2h,俯卧位翻身次数为3次,其余时间为平卧或侧卧位通气;观察两组患者俯卧位1周内的并发症发生率、舒适度和治疗效果。结果两组1周内并发症、舒适度、翻身后的心率、平均动脉压、潮气量、氧分压等指标的差异均无统计学意义(P>0.05)。结论 ARDS机械通气患者俯卧位不同时间翻身患者均能够耐受,可以适当延长翻身时间,减少翻身次数,以减少患者氧耗,降低护理难度和风险。

Objective To compare the incidence of complications, patients＇ comfort and treatment outcomes between different time of position change for acute respiratory distress syndrome（ARDS） patients treated with prone position mechanical ventilation （PPMV）. Methods Seventy-six ARDS patients were divided into two groups according to the serial numbers of admission and treated with PPMV for 6 hours every day. The patients in the experimental group were kept in prone position for 3 hours and then turned to supine position, the patients in the control group were kept in prone position for 2 hours and then turned to supine position. The incidence of complications within a week,including patients＇ comfort and treatment outcomes were compared between the two groups. Results There were no significant differences in the incidence of complications within a week,including patients＇ comfort,heart rate（HR）,mean arterial pressure（MAP）,tidal volume（VT） and arterial oxygen partial pressure（PaO2） between the two groups（P〉0.05）. Conclusion The ARDS patients can tolerate the prolonged duration of position change. It is suggested to prolong the duration of position change and decrease the times of position change to reduce oxygen consumption and nursing workload.