急性低氧性呼吸衰竭患者清醒俯卧位通气依从性现状分析

Analysis of the compliance to awake prone position ventilation in patients with acute hypoxic respiratory failure

目的:调查急性低氧性呼吸衰竭患者对清醒俯卧位通气的依从性现状并分析其影响因素,为制定相应的改善策略提供参考。方法:采用便利抽样法,于2022年12月至2023年2月应用一般信息调查表、自制清醒俯卧位通气依从性阻碍因素问卷、Barthel指数量表和数字疼痛评定量表对上海市某医院的急性低氧性呼吸衰竭患者进行调查。结果:85例患者参与调查,患者每日清醒俯卧位时间为4(2,6)小时,其中依从性好的患者30例(35.3%)。清醒俯卧位通气最常见的阻碍因素分别为:没有及时更换体位以缓解俯卧位的不适(63.5%)、对于俯卧位通气治疗意义的认识不足(42.4%)、对于疾病恢复缺乏信心(27.1%)。Logistic回归分析结果显示,疼痛程度是患者清醒俯卧位通气依从性的影响因素(P<0.05)。结论:急性低氧性呼吸衰竭患者对清醒俯卧位通气依从性不佳,疼痛程度较高的患者俯卧位实施情况较差。医疗团队应重视急性低氧性呼吸衰竭患者对清醒俯卧位通气的依从性现状,制定相应改善策略,以提高患者的耐受性,改善清醒俯卧位治疗依从性,进而提高患者的治疗效果。

Objective:To investigate the current status of awake prone position ventilation compliance in patients with acute hypoxic respiratory failure and analyze its influencing factors,in order to provide reference for formulating corresponding improvement strategies.Methods:From December 2022 to February 2023,convenience sampling was used to investigate patients with acute hypoxic respiratory failure in a hospital in Shanghai with the general information questionnaire,self-developed Obstacles to Awake Prone Position Ventilation Compliance Questionnaire,Barthel Index Scale and Numerical Pain Rating Scale.Results:A total of 85 patients participated in the survey.The time of awake prone position was 4(2,6)hours per day,and 30 patients(35.3%)had good compliance.The most common hindering factors were:failure to change position in time to relieve the discomfort of prone position(63.5%),insufficient understanding of the significance of prone position ventilation(42.4%),and lack of confidence in disease recovery(27.1%).Logistic regression results showed that numerical pain score was the influencing factor of compliance in patients with awake prone position(P<0.05).Conclusion:The compliance of awake prone position ventilation in patients with acute hypoxic respiratory failure is poor,and the implementation of prone position is poor in patients with higher numerical pain scores.Medical teams should pay attention to the compliance status of awake prone position in patients with acute hypoxic respiratory failure,and formulate corresponding improvement strategies to enhance the tolerance of patients,improve the compliance of awake prone position treatment,and thereby improve the treatment effects of patients.