基于外周灌注指数的针对性护理在体外膜肺氧合救治呼吸衰竭患者中的应用

Application of Targeted Nursing Based on Peripheral Perfusion Index in Respiratory Failure Patients Treated with Extracorporeal Membrane Oxygenation

目的:探讨基于外周灌注指数(PI)的针对性护理在体外膜肺氧合(ECMO)救治呼吸衰竭患者中的应用。方法:回顾性收集2018年2月—2020年3月河南科技大学第一附属医院收治的90例应用ECMO救治的呼吸衰竭患者的临床资料,根据自愿选择的护理方法不同将患者分为两组,对照组42例,研究组48例。对照组给予常规护理,研究组采用基于PI的针对性护理。比较两组患者氧代谢状况,包括氧输送指数(DO_(2)I)、氧摄取率(O_(2)ER)、动脉血氧分压(PaO_(2))、静脉血氧饱和度(SVO_(2)),以及肺功能指标和恢复情况。结果:研究组干预后,O2ER较对照组降低,DO_(2)I、PaO_(2)、SVO_(2)较对照组均升高,差异有统计学意义(t=5.443、5.380、5.056、12.275,P<0.05);研究组肺功能指标,包括用力肺活量(FVC)、一秒用力呼气容积(FEV1)、一秒用力呼气容积与用力肺活量的比值(FEV1/FVC)较对照组均明显升高,差异有统计学意义(t=8.274、11.065、4.718,P<0.05);研究组呼吸功能恢复时间、住院时间均短于对照组,差异有统计学意义(t=14.099、9.550,P<0.05)。结论:对应用ECMO救治的呼吸衰竭患者采取基于PI的针对性护理,可改善氧代谢状况,促进肺功能恢复,缩短患者呼吸功能恢复时间及住院时间,值得临床进一步推广。

Objective:To investigate the application of targeted nursing based on peripheral perfusion index(PI)in respiratory failure patients treated with extracorporeal membrane oxygenation(ECMO).Methods:The clinical data of 90 respiratory failure patients treated with ECMO in the hospital from February 2018 to March 2020 were retrospectively collected.According to the nurs⁃ing method chosen voluntarily,the patients were divided into control group(42 cases)and study group(48 cases).The control group was given routine care,and the study group was given PI-based targeted care.The oxygen metabolism status,including oxygen delivery index(DO_(2)I),oxygen extraction rate(O_(2)ER),arterial partial pressure of oxygen(PaO_(2))and venous blood oxygen saturation(SVO_(2)),lung function indicators and recovery condition were compared between the two groups.Results:After the intervention,O_(2)ER in the study group was lower than that in the control group,and DO_(2)I,PaO_(2),and SVO_(2) were higher than those in the control group.The difference was statistically significant(t=5.443,5.380,5.056,12.275,P<0.05).The lung function indexes of the study group,including forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and the ratio of forced expi⁃ratory volume in one second to forced vital capacity(FEV1/FVC)were significantly higher than those in the control group,and the differences were statistically significant(t=8.274,11.065,4.718,P<0.05).Respiratory function recovery time and hospital stay in the study group were shorter than those in the control group,and the difference was statistically significant(t=14.099,9.550,P<0.05).Conclusion:Applying PI-based targeted nursing to patients with respiratory failure treated by ECMO can improve their oxygen metabolism,promote lung function recovery,and shorten the respiratory function recovery time as well as hospital stay.It is worthy of clinical promotion.