不同体位对病毒性肺炎伴呼吸衰竭患者治疗效果的影响

Effect of different positions on the treatment of viral pneumonia with respiratory failure

目的探讨不同体位(坐位、俯卧位、侧卧位)对病毒性肺炎伴呼吸衰竭患者治疗效果的影响。方法将2023年1月攀枝花市人民医院收治的66例病毒性肺炎伴Ⅰ型呼吸衰竭患者分为俯卧位组(39例)、侧卧位组(19例)和坐位组(8例)。比较3组患者体位执行前、执行后10 min及执行后24 h的CRB-65评分、血气分析指标和血流动力学指标。结果3组患者体位执行前、体位执行后10 min及体位执行后24 h的CRB-65评分、氧合指数(PaO_(2)/FiO_(2))水平、动脉血氧饱和度(SpO_(2))水平、心率(HR)及平均动脉压(MAP)水平比较,差异均无统计学意义(P>0.05)。3组患者体位执行前及执行后24 h的呼吸频率(RR)比较,差异无统计学意义(P>0.05);俯卧位和侧卧位组患者体位执行后10 min的RR均低于坐位组患者,差异有统计学意义(P<0.05)。结论对于病毒性肺炎伴呼吸衰竭患者,采用俯卧位比侧卧位和坐位更安全,3种体位对改善患者氧合效果不明显。

Objective To explore the effect of different positions(sitting,prone,lateral)on the treatment of viral pneumonia with respiratory failure.Methods Sixty-six patients with viral pneumonia and type I respiratory failure admitted to Panzhihua People's Hospital in January 2023 were allocated to the prone position group(n=39),lateral position group(n=19),and sitting position group(n=8).The CRB-65 scores,blood gas analysis,and hemodynamic indices were compared before and 10 minutes and 24 hours after positioning among the three groups.Results No statistically significant differences were found in the CRB-65 scores,oxygenation index(PaO_(2)/FiO_(2)),arterial oxygen saturation(SpO_(2)),heart rate(HR),and mean arterial pressure(MAP)among the three groups before positioning,10 minutes after positioning,and 24 hours after positioning(P>0.05).No statistically significant differences were observed in respiratory rate(RR)before positioning and 24 hours after positioning among the three groups(P>0.05);however,the RR of the prone and lateral position groups was significantly lower than that of the sitting position group 10 minutes after positioning(P<0.05).Conclusion For patients with viral pneumonia and respiratory failure,the prone position is safer compared to the lateral and sitting positions,although the three positions do not significantly promote oxygenation.