临床误诊误治2024，Vol.37Issue(6)：24-29,6.DOI:10.3969/j.issn.1002-3429.2024.06.006
改良俯卧位通气对清醒病毒性肺炎患者呼吸循环、康复指标及并发症的影响
Effect of Modified Prone Position Ventilation on Respiratory Circulation,Rehabilitation Indicators,and Complications in Conscious Patients with Vi-ral Pneumonia
摘要
Abstract
Objective To investigate the effects of modified prone position ventilation(PPV)on respiratory circula-tion,rehabilitation indicators,and complications in conscious patients with viral pneumonia(VP).Methods In total,134 VP patients treated from August 2021 to June 2023 were selected and divided into research group(n=67)and control group(n=67)according to the random number table method.The control group received conventional PPV,while the research group re-ceived modified PPV.The rehabilitation indicators,blood gas indicators[oxygenation index ratio of arterial partial pressure(PaO2)of oxygen to fractional inspired oxygen(PaO2/FiO2),arterial partial pressure of carbon dioxide(PaCO2),blood oxy-gen saturation(SpO2)],hemodynamic indicators[heart rate(HR),central venous pressure(CVP),mean arterial pressure(MAP)],respiratory function indicators[plateau pressure(Pplat),airway peak pressure(Ppeak),mean airway pressure(Pmean)],inflammatory indicators[interleukin-6(IL-6),granulocyte-macrophage colony stimulating factor(GM-CSF),tumor necrosis factor-α(TNF-α)],complications,and incidence of pressure injury were compared between the two groups.Results The length of hospitalization was shorter in the research group than in the control group(P＜0.05).The PaCO2,PaO2,PaO2/FiO2,SpO2 at 2,4,8,12,and 16 h in prone position,as well as Ppeak,Pmean,Pplat,GM-CSF,IL-6,and TNF-α at 24 and 36 h in prone position,were significantly improved compared with those before prone position in both groups(P＜0.05),which,however,showed no significant difference(P＞0.05).There was no significant intergroup and intra-group difference in CVP,MAP,and HR at different time points(P＞0.05).The total incidence of complications was lower in research group than in control group[2.99%(2/67)vs.(11.94%(8/67))],and the incidence of pressure injury was lower than that of control group[2.99%(2/67)vs.(13.43%(9/67)](P＜0.05).Conclusion In conscious patients with VP,modified PPV can achieve similar auxiliary therapeutic effects as conventional PPV,improve oxygenation and respir-atory circulation functions,reduce the risk of complications and pressure injury,and accelerate the recovery of the disease.关键词
肺炎,病毒性/改良俯卧位通气/血气分析/血流动力学/白细胞介素-6/肿瘤坏死因子-α/平均气道压/并发症Key words
Pneumonia,viral/Modified prone position ventilation/Blood gas analysis/Hemodynamics/Interleukin-6/Tumor necrosis factor-α/Mean airway pressure/Complications分类
临床医学引用本文复制引用
姚娜,柳娟娟,张婷婷..改良俯卧位通气对清醒病毒性肺炎患者呼吸循环、康复指标及并发症的影响[J].临床误诊误治,2024,37(6):24-29,6.基金项目
张家口市重点研发计划项目(2322043D) （2322043D）
