不同时长俯卧位通气在AECOPD有创机械通气患者的临床疗效观察

目的探讨不同时长俯卧位通气在慢性阻塞性肺疾病急性加重期(AECOPD)需有创机械通气患者的临床效果。方法选取2022年9月至2023年12月本院ICU接受治疗的60例AECOPD患者,随机分为观察组30例(通气时长8 h)和对照组30例(通气时长4 h)。比较两组患者治疗3 d后的氧合指数、拔除气管插管时间,并比较两组患者压疮、血流动力学不稳定及气管插管滑脱等不良事件发生率。结果两组患者治疗3 d后的氧合指数均高于治疗前(P<0.05),观察组患者氧合指数高于对照组(P<0.05),拔除气管插管时间较对照组短(P<0.05),且不良事件发生率较对照组低(P<0.05)。结论延长俯卧位通气时间可以提高患者氧合指数,缩短拔管时间,且不会增加不良反应的风险,具有重要的临床应用价值。

Objective To explore the clinical effects of different durations of prone position ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)requiring invasive mechanical ventilation.Methods A total of 60 AECOPD patients treated in the ICU of our hospital from September 2022 to December 2023 were selected and randomly divided into two groups:the observation group(30 cases with a ventilation duration of 8 hours)and the control group(30 cases with a ventilation duration of 4 hours).The oxygenation index and the time to remove the tracheal intubation were compared after 3 days of treatment in both groups,as well as the incidence of pressure sores,hemodynamic instability,and tracheal intubation displacement,etc.Results The oxygenation index of patients in both groups was higher than before treatment after 3 days(P<0.05),and the observation group's oxygenation index was higher than that of the control group(P<0.05).The time to remove the tracheal intubation was shorter than that of the control group(P<0.05),and the incidence of adverse events was lower than that of the control group(P<0.05).Conclusion Prolonging the duration of prone position ventilation can improve the oxygenation index of patients,shorten the intubation time,and will not increase the risk of adverse reactions,which has important clinical application value.