俯卧位通气患者使用平躺式移位机的安全性及有效性评价

Evaluation of the safety and effectiveness of using a shifting machine for patients with prone position ventilation

目的 评价俯卧位通气患者使用平躺式移位机的安全性及有效性。方法 选取2022年12月-2023年2月杭州市某三级甲等医院ICU收治的100例采用俯卧位通气治疗的重度急性呼吸窘迫综合征患者为研究对象,按照随机数字表法分为试验组50例和对照组50例。试验组采用平躺式移位机实施俯卧位通气,共计实施500次;对照组采用传统方法实施俯卧位通气,共计实施510次。比较两组实施俯卧位所需用时、所需医护人员数、不良事件(导管移位、导管滑脱、导管阻塞、关节脱臼)的发生率和医护人员满意度。结果 试验组使用平躺式移位机实施俯卧位通气的用时为(300.24±11.88) s,少于对照组使用传统方法实施俯卧位通气所需用时(357.50±20.36) s,差异有统计学意义(P<0.001);使用平躺式移位机实施俯卧位通气所需医护人员中位数为3(3,3)名,使用传统方法需医护人员中位数为5(4,6)名,差异有统计学意义(Z=-28.450,P<0.001);使用平躺式移位机实施俯卧位通气可提高医护人员的满意度,满意度总分中位数从7(7,8)分升高至8(8,9)分,差异有统计学意义(Z=-6.177,P<0.001);两组应用期间均未发生不良事件。结论 在不增加医疗风险的前提下,使用平躺式移位机不仅可提高俯卧位通气治疗的实施效率,还可减轻医护人员劳动强度,进而提高医护人员满意度。

Objective To evaluate the safety and effectiveness of using a shifting machine for patients with prone position ventilation.Methods A research study was conducted with a total of 10O severe ARDS patients treated with prone position ventilation from the critical care department of a tertiary class A hospital in Hangzhou from December 2022 to February 2023.The patients were randomly allocated into the experimental group consisting of 50 cases and the control group consisting of 50 cases by the random number table.In the experimental group.prone position ventilation was administered by using a shifting machine,and implemented for a total of 500 times.The control group received prone position ventilation by using traditional method,and it was implemented a total of 510 times.The study compared several outcome indicators between the two groups,including the time required for prone position implementation,the number of medical staffs involved,the occurrence of adverse events such as tube displacement,tube slippage,tube obstruction,and joint dislocation,as well as the satisfaction of medical staffs.Results The time required for prone position ventilation in the group using shifing machine was(300.24±11.88)seconds which was less than that in the group using traditional method(357.50±20.36)seconds,the difference was statistically significant(P<0.001).The number of medical staffs required for prone position ventilation in the group using shifting machine was 3(3,3),which was less than that in the group using traditional method 5(4,6),with statistically significant difference(Z=-28.450,P<0.001).The total satisfaction score of medical staffs in the group using shifting machine was 8(8,9)points,which was higher than that in the group using traditional method 7(7,8)points,with statistically significant difference(Z=-6.177,P<0.001).No adverse events occurred in either group during the application period.Conclusion The use of a lying shifing machine can not only improve the efficiency of prone position ventilation treatment without increasing medical risks but also reduce the workload of medical staffs and improvetheir satisfaction.