体位指导联合气道干预在老年重症肺炎患者呼吸机治疗中的应用效果

Application Effect of Postural Guidance Combined Airway Intervention in Ventilator Treatment of Elderly Patients with Severe Pneumonia

目的:探讨体位指导联合气道干预在老年重症肺炎患者呼吸机治疗中的应用效果。方法:选取2022年1月—2023年1月广州市第一人民医院收治的60例老年重症肺炎患者。根据随机数表法将其分为对照组和观察组,各30例。对照组采用常规护理,观察组在对照组基础上采用体位指导联合气道干预。比较两组干预前、干预7 d后心功能及肾功能指标、应激指标及并发症。结果:干预7 d后,两组左室射血分数(LVEF)升高,舒张早期充盈峰速度/舒张晚期充盈峰速度(E/A)、血肌酐、血尿素氮(BUN)均降低,观察组LVEF高于对照组,血肌酐、BUN均低于对照组,差异有统计学意义(P<0.05)。干预7 d后,两组皮质醇(Cor)、血管紧张素Ⅰ(AngⅠ)及血管紧张素Ⅱ(AngⅡ)均降低,观察组Cor、AngⅠ、AngⅡ均低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:体位指导联合气道干预用于老年重症肺炎患者呼吸机治疗中,能改善患者心功能及肾脏功能,减轻应激反应及降低并发症发生率。

Objective:To explore the application effect of postural guidance combined airway intervention in ventilator treatment of elderly patients with severe pneumonia.Method:A total of 60 elderly patients with severe pneumonia treated in Guangzhou First People's Hospital from January 2022 to January 2023 were selected.They were divided into control group and observation group according to random number table method,with 30 cases in each group.The control group received routine nursing,and the observation group received postural guidance combined airway intervention on the basis of the control group.Cardiac and renal function indexes,stress indexes before intervention and after 7 d of intervention and complications were compared between the two groups.Result:After 7 d of intervention,left ventricular ejection fraction(LVEF)increased,and early diastolic filling peak velocity/late diastolic filling peak velocity(E/A),serum creatinine and blood urea nitrogen(BUN)decreased in both groups,LVEF in observation group was higher than that in control group,and serum creatinine and BUN were lower than those in control group,the differences were statistically significant(P<0.05).After 7 d of intervention,cortisol(Cor),angiotensinⅠ(AngⅠ)and angiotensin Ⅱ(AngⅡ)were decreased in both groups,and Cor,AngⅠ and AngⅡ in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Postulation guided combined airway intervention in ventilator treatment of elderly patients with severe pneumonia can improve heart function and kidney function,reduce stress response and decrease the incidence of complication.