多部位俯卧位乳胶垫在重度急性呼吸窘迫综合征行俯卧位通气患者中的应用效果

Effect of multi position prone position latex pad on patients with severe acute respiratory distress syndrome undergoing prone position ventilation

目的探讨多部位俯卧位乳胶垫在重度急性呼吸窘迫综合征行俯卧位通气患者中的应用效果,旨在改善患者氧合治疗效果及降低俯卧位通气相关并发症。方法采用随机对照试验方法,便利抽样法选取2020年2月至2022年2月入住盐城市第一人民医院ICU的80例重度急性呼吸窘迫综合征行俯卧位通气患者为研究对象。采用随机数字法分为试验组和对照组,每组40例。对照组采用软枕垫实施传统俯卧位通气治疗,试验组采用自制多部位俯卧位乳胶垫实施俯卧位通气治疗。比较2组患者氧合治疗效果(氧合指数和PaCO_(2))、并发症(压力性损伤、人工气道管道滑脱、人工气道管道弯折)发生率以及护理工作量(翻身时长、总治疗时长)指标情况。结果干预后试验组患者氧合指数和PaCO_(2)分别为(265.79±21.15)、(31.52±3.43)mmHg(1 mmHg=0.133 kPa),对照组分别为(177.43±17.76)、(39.73±4.80)mmHg,2组比较差异均有统计学意义(t=15.43、10.17,均P<0.05)。试验组压力性损伤和人工气道管道弯折发生率分别为7.5%(3/40)、0,对照组分别为37.5%(15/40)、20.0%(8/40),2组比较差异均有统计学意义(χ^(2)=10.32、8.89,均P<0.05);试验组和对照组人工气道管道滑脱发生率分别为0、7.5%(3/40),2组比较差异无统计学意义(χ^(2)=3.12,P>0.05)。试验组俯卧位翻身时长和总治疗时长分别为(3.56±0.53)min和(34.47±3.72)h,对照组分别为(5.18±0.61)min和(50.22±4.60)h,2组比较差异均有统计学意义(t=6.25、13.55,均P<0.05)。结论将多部位俯卧位乳胶垫应用于重度急性呼吸窘迫综合征患者,能够明显改善患者的氧合效果、降低并发症发生率以及降低护理工作量,值得在临床推广应用。

Objective To investigate the effect of multi position prone position latex pad in patients with severe acute respiratory distress syndrome undergoing prone position ventilation,aiming to improve the effect of oxygenation therapy and reduce the complications associated with prone ventilation.Methods A randomized controlled trial was used to select 80 patients with prone ventilation with severe acute respiratory distress syndrome who were admitted to the ICU of Yancheng First People's Hospital from February 2020 to February 2022 by convenient sampling method.The random number method was used to divide into experimental group and control group,with 40 cases in each group.The control group used soft pillow cushions for traditional prone ventilation,and the experimental group used homemade multi-site prone latex pads for prone ventilation.The effects of oxygenation therapy(oxygenation index and PaCO2),the incidence of complications(pressure injury,artificial airway tube slippage,artificial airway tube bending)and nursing workload(length of turning over and total treatment time)were compared between the two groups.Results After the intervention,the oxygenation index and PaCO2 in the experimental group was(265.79±21.15),(31.52±3.43)mmHg(1 mmHg=0.133 kPa)respectively,and the control group was(177.43±17.76),(39.73±4.80)mmHg respectively and the differences between the two groups were statistically significant(t=15.43,10.17,both P<0.05).The incidence of pressure injury and artificial airway tube bending in the experimental group was 7.5%(3/40)and 0 respectively,and the control group was 37.5%(15/40)and 20.0%(8/40)respectively,and the differences between the two groups were statistically significant(χ^(2)=10.32,8.89,both P<0.05).The incidence of artificial airway tube slippage in the experimental group and the control group was 0 and 7.5%(3/40)respectively,and there was no significant difference between the two groups(χ^(2)=3.12,P>0.05).The duration and total treatment duration of prone turning in the experimental group was(3.56±0.53)min and(34.47±3.72)h respectively,and the control group was(5.18±0.61)min and(50.22±4.60)h respectively,and the differences between the two groups were statistically significant(t=6.25,13.55,both P<0.05).Conclusions The application of multi position prone position latex pad in patients with severe acute respiratory distress syndrome can significantly improve the oxygenation effect,reduce the incidence of complications and reduce the workload of nursing,which is worthy of clinical application.