床旁端坐法在重症急性胰腺炎机械通气患者中的应用

doi:10.3761/j.issn.0254-1769.2019.06.005

摘要/Abstract

摘要：

目的探讨床旁端坐法在重症急性胰腺炎合并急性呼吸窘迫综合征机械通气患者中的应用效果。方法本研究采用类实验性研究方法,组建床旁端坐管理团队。选取2016年3月—2018年7月的30例患者作为实验组,接受床旁端坐;选取2014年1月—2016年2月的28例患者作为对照组,接受常规护理。比较两组ICU获得性衰弱的发生率、机械通气时间、ICU住院时间、拔除气管插管前(脱离呼吸机30 min)氧合指数、不良事件的发生率。结果实验组、对照组的ICU获得性衰弱的发生率分别为26.60%、57.14%,实验组、对照组的机械通气时间为(5.94±1.05) d、(8.47±1.45) d,ICU住院时间为(7.11±0.99) d、(9.93±2.06) d,两组比较,差异均有统计学意义(P<0.05)。实验组、对照组的拔除气管插管前(脱离呼吸机30 min)氧合指数为(294.20±21.18) mmHg(1 mmHg=0.133 kPa)和(290.96±27.36) mmHg,实验组、对照组的不良事件发生率分别3.30%、0,两组比较,差异无统计学意义(P>0.05)。结论床旁轮椅端坐可有效降低ICU获得性衰弱的发生率,缩短机械通气时间及ICU住院时间,并且安全有效,具有良好的临床应用意义。

关键词: 床旁端坐, 机械通气, 重症急性胰腺炎, 急性呼吸窘迫综合征, 护理

Abstract:

Objective To explore the application effects of bedside wheelchair seating in patients with severe acute pancreatitis and acute respiratory distress syndrome undergoing mechanical ventilation.Methods Semi-experimental research method was used. We set up a management team for bedside wheelchair sitting,and implemented early activities using bedside wheelchair seating. A total of 30 patients were selected as the experimental group between March 2016 and July 2018,and were treated with beside wheelchair seating. A total of 28 patients were selected as the control group between January 2014 and February 2016,and received routine treatment. The incidence of ICU acquired debilitation,the length of mechanical ventilation,the length of stay in ICU,the oxygenation index before withdrawing tracheal tube(30 min from the ventilator),and the incidence of adverse events in two groups were compared.Results The incidence of ICU acquired debilitation in the experimental group and in the control group was 26.60% (8 cases) and 57.14% (16 cases),and the difference was statistically significant(P<0.05);the length of mechanical ventilation was (5.94±1.05) d and (8.47±1.45) d,the length of stay in ICU was (7.11±0.99) d,(9.93±2.06) d,and the differences were statistically significant(P<0.05). The oxygenation index was (294.20± 21.18) mmHg and(290.96±27.36) mmHg without statistically significant difference(P>0.05);the incidence of adverse events was 3.30% (1 case)and 0.00% (0 cases),respectively,and the difference was not statistically significant(P>0.05).Conclusion The bedside wheelchair sitting can effectively help patients to prevent the occurrence of ICU acquired debilitation,shorten the length of mechanical ventilation and stay in ICU. It is safe and effective,and has good clinical application value.

Key words: Beside Wheelchair Sitting, Mechanical Ventilation, Severe Acute Pancreatitis, Acute Respiratory Distress Syndrome, Nursing Care

王玉光, 叶蕊, 马佳, 刘丽丽, 王宏伟, 梁子薇, 刘冬梅, 蔡彤鑫, 任秀辉, 张喜维. 床旁端坐法在重症急性胰腺炎机械通气患者中的应用[J]. 中华护理杂志, 2019, 54(6): 829-834.

WANG Yuguang, YE Rui, MA Jia, LIU Lili, WANG Hongwei, LIANG Ziwei, LIU Dongmei, CAI Tongxin, REN Xiuhui, ZHANG Xiwei. Effects of bedside wheelchair seating in patients with severe acute pancreatitis combined with mechanical ventilation[J]. Chinese Journal of Nursing, 2019, 54(6): 829-834.

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