综合性护理干预在俯卧位机械通气患者中预防压力性损伤的效果研究

Nursing Intervention and Effect Study on Prevention of Skin Pressure Sore in Patients Treated with Mechanical Ventilation in Prone Position

目的:探讨综合性护理干预在俯卧位机械通气患者中的应用效果,为预防皮肤压力性损伤的发生提供依据。方法:选取2019年12月—2021年2月郑州大学第一附属医院收治的90例俯卧位机械通气患者作为对照组;选取2021年3月—2022年2月样本医院收治的102例俯卧位机械通气患者作为观察组。对照组采用常规护理干预,观察组在常规护理基础上实施综合性护理干预。比较两组患者皮肤压力性损伤事件发生率、护理服务满意度、护理前后血氧相关指标[动脉二氧化碳分压(PaCO_(2))、动脉氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))]和呼吸功能[呼气峰值流速(PEF)、一秒用力呼气容积(FEV1)、第一秒用力呼气容积占用力肺活量百分比(FEV1/FVC)]水平。结果:观察组患者皮肤压力性损伤等级发生率明显低于对照组,差异有统计学意义(χ^(2)=4.767、6.560、5.532、3.454,P<0.05)。观察组患者护理服务满意度明显高于对照组,差异有统计学意义(χ^(2)=6.658,P<0.05)。护理后,观察组患者PaCO_(2)水平低于对照组,SaO_(2)、PaO_(2)水平高于对照组,差异有统计学意义(t=7.159、5.427、14.317,P<0.05)。护理后,观察组患者PEF、FEV1、FEV1/FVC指标明显高于对照组,差异有统计学意义(t=4.679、5.426、8.520,P<0.05)。结论:俯卧位机械通气患者接受综合性护理干预,可以预防患者皮肤压力性损伤事件发生,改善呼吸功能和血氧相关指标,提升护理服务满意度。

Objective:To investigate the efficacy of comprehensive nursing interventions in mechanically ventilated patients in the prone position to provide a basis for preventing the occurrence of skin pressure injuries.Methods:90 patients with prone position mechanical ventilation admitted to the hospital from December 2019 to February 2021 were selected as the control group,and 102 patients with prone position mechanical ventilation admitted to the hospital from March 2021 to February 2022 were selected as the observation group.The control group used conventional nursing interventions,and the observation group implemented comprehensive nursing interventions on the basis of conventional nursing.The incidence rate of skin pressure injury events,satisfaction with nursing services,blood oxygen-related indexes[peak expiratory flow(PEF),forced exhale volume in one second(FVE1),expiratory volume in the firse second of exertion as a percentage of exerted lung volume(FEV1/FVC)]and respiratory function(partial pressure of arterial carbon dioxide[PaCO2],partial pressure of arterial oxygen[PaO2],arterial oxygen saturation[SaO2])levels before and after nursing care were compared between the two groups.Results:The incidence of skin pressure injury grade in the observation group was significantly lower than that in the control group,and the difference was statistically significant(χ^(2)=4.767,6.560,5.532,3.454,P<0.05).The satisfaction with nursing services in the observation group was significantly higher than that in the control group,and the difference was statistically significant(χ^(2)=6.658,P<0.05).After care,the PaCO2 level of the observation group was lower than that of the control group,and the SaO2 and PaO2 levels were higher than that of the control group,and the differences were statistically significant(t=7.159,5.427,14.317,P<0.05).After care,the PEF,FEV1,and FEV1/FVC indexes of the observation group were significantly higher than those of the control group,and the differences were statistically significant(t=4.679,5.426,8.520,P<0.05).Conclusion:Comprehensive nursing interventions for mechanically ventilated patients in the prone position can prevent the occurrence of skin pressure injury events,improve respiratory function and blood oxygenation-related indices,and enhance satisfaction with nursing services.