甲型H1N1流感患者机械通气中俯卧位的应用与护理

Application and Nursing of Prone Position in Mechanical Ventilation for Patients with Influenza A H1N1

目的观察在甲型H1N1流感患者中进行机械通气时俯卧位的应用及效果,并探讨其中的具体护理措施。方法选择本科室2013年6月～2017年6月期间收治的39例甲型H1N1流感患者为观察对象,将患者随机分组后,对照组19例,观察组20例;对照组和观察组均以机械通气治疗为主,其中,对照组患者在进行机械通气治疗的过程中,以常规护理方式进行,观察组则在常规护理的基础上实施俯卧位的体位护理干预,而后对比两组患者治疗及护理效果。结果上机6小时后,对照组患者心率为(118.7±11.6)次/min,平均动脉压为(79.2±5.4)mmHg,动脉血氧分压为(65.1±6.1)mmHg,潮气量为(413.3±30.2)m L;气胸8例,死亡9例。观察组患者的心率为(113.5±11.3)次/min,平均动脉压为(75.6±5.1)mmHg,动脉血氧分压为(82.4±6.7)mmHg,潮气量为(491.1±31.4)mL;气胸4例,死亡4例。两组患者治疗及护理结果对比,差异具有统计学意义(P<0.05)。结论针对甲型H1N1流感患者进行机械通气治疗的过程中,重点以俯卧位的方式开展治疗和护理,能够有效降低患者并发症的发生概率,取得良好的临床救治效果,因此可在临床当中推广应用俯卧位机械通气进行甲型H1N1流感患者的治疗和护理。

Objective To observe the application and effect of mechanical ventilation in prone position in patients with influenza a(H1N1),and explore the specific nursing measures.Methods A total of39cases of influenza a(H1N1)patients admitted and treated in the undergraduate department from June2013to June2017were selected as the observation objects.The patients were randomly divided into19cases in the control group and20cases in the observation group.The control group and the observation group were mainly treated with mechanical ventilation.Among them,patients in the control group received routine care.In the observation group,the nursing intervention of prone position was carried out on the basis of routine nursing.Then the two groups of patients treatment and nursing effect was compared.Results After6hours of wearing the ventilator,the heart rate of patients in the control group was(118.7±11.6)times/min,and the average arterial pressure was(79.2±5.4)mmHg,arterial blood oxygen partial pressure(65.1±6.1)mmHg,and the tidal volume was(413.3±30.2)mL.Pneumothorax was found in8cases and9deaths.The heart rate of the patients in the observation group was(113.5±11.3)times/min,the average arterial pressure was(75.6±-5.1)mmHg,the arterial blood oxygen partial pressure was(82.4±6.7)mmHg,and the tidal volume was(491.1±31.4)mL.Pneumothorax was found in4cases and death in4cases.Conclusion In the course of mechanical ventilation treatment for patients with influenza a(H1N1),the emphasis is on the prone position for treatment and nursing,which can effectively reduce the incidence of complications in patients and achieve good clinical treatment effect.Therefore,the application of prone position mechanical ventilation can be promoted in clinical treatment and nursing of patients with influenza a(H1N1).