俯卧位治疗ARDS的呼吸道感染相关性研究

Research on prone position in treatment of respiratory tract infections caused by ARDS

目的研究俯卧位治疗急性呼吸窘迫综合征(acute respiratory distresssyndrome,ARDS)呼吸道感染的相关性因素。方法选取中国石油天然气集团公司中心医院2015年5月—2016年5月70例行俯卧位通气治疗的ARDS患者作为研究对象,依据是否发生呼吸道感染分为感染组(20例)及未感染组(50例),对两组患者资料进行分析并采用Logistic回归分析模型对其独立危险因素进行分析。结果两组患者除性别、病程时间外,年龄、俯卧位治疗时间、APACHEⅡ评分、MODS评分、血气指标、心率两组间相比较,差异有统计学意义(P<0.05);Logistic回归分析结果提示,年龄、俯卧位治疗时间为俯卧位治疗ARDS致呼吸道感染的独立危险因素(OR:2.896、4.244,OR 95%CI:1.599~2.384、1.677~4.544,P<0.05)。结论针对高龄以及俯卧位治疗时间较长者实施更加精细的护理干预将有助于降低呼吸道感染发生率,为患者生命安全提供保障。

Objective To study the relevance of prone position in the treatment of respiratory tract infections caused byacute respiratory distress syndrome（ARDS）. Methods From May 2015 to May 2016, 70 ARDS patients treated by proneposition were divided into an infection group（20 cases） and a non-infection group（50 cases） according to whether the patientshad a respiratory tract infection. The data of the two groups were analyzed and the independent risk factors were analyzed bythe logistic regression analysis model. Results Except the gender and disease duration, the difference of the age, proneposition treatment time, APACHEll score, MODS score, blood gas index, and heart rate were statistically significant betweenthe two groups（all P〈0.05）. The logistic regression analysis showed that the age and prone position treatment time wereindependent risk factors in the treatment of respiratory tract infection caused by ARDS（OR： 2.896 and 4.244, OR 95%CI：1.599-2.384 and 1.677-4.544, respectively, both P〈0.05）. Conclusion For the elderly patients with the prone positiontherapy for a long time, the meticulous nursing care can help to reduce the incidence of respiratory infection.