俯卧位通气干预护理对新生儿急性呼吸窘迫综合征的作用研究-现代医学

俯卧位通气干预护理对新生儿急性呼吸窘迫综合征的作用研究

单位：攀枝花市中心医院新生儿科, 四川攀枝花 617000

分类号：R473.72

出版年·卷·期（页码）：2019·38·第十一期（1420-1423）

摘要：

目的：探讨俯卧位通气干预护理在新生儿呼吸窘迫综合征（NRDS）中的应用效果。方法：选取2017年1月至2018年3月在攀枝花市中心医院接受治疗的90例NRDS患儿为研究对象，随机将其分为对照组和研究组，每组各45例。对照组患儿采用常规机械通气干预护理，研究组采用俯卧位通气干预护理，监测并记录两组患儿治疗前后血气分析指标和血流动力学指标，观察并记录两组患儿使用机械通气时间、吸氧时间、住院时间、呼吸机相关肺炎发生率、压力性损伤发生率。结果：研究组患儿机械通气治疗1、2、6 h后，二氧化碳分压（PaCO₂）低于对照组，血氧分压（PaO₂）和氧合指数（PaO₂/FiO₂）均高于对照组，差异均具有统计学意义（P<0.05）。两组患儿机械通气治疗1、2、6 h后血流动力学指标心率（HR）、中心静脉压（CVP）、平均动脉压（MAP）比较，差异均无统计学意义（P>0.05）；研究组患儿使用机械通气时间低于对照组，差异具有统计学意义（P<0.05）；两组患儿呼吸机相关肺炎发生率、压力性损伤发生率差异无统计学意义（P>0.05）。结论：俯卧位通气方式可有效改善NRDS患儿的氧合功能，缩短机械通气时间，提高新生儿护理质量。

Objective: To investigate nursing interventions based on prone position ventilation in neonatal respiratory distress syndrome(NRDS). Methods: 90 cases of NRDS in Panzhihua Central Hospital from January 2017 to March 2018 were selected as subjects. They were randomly divided into control group and study group, 45 cases in each group. In the control group, the patients were treated with conventional mechanical ventilation and nursing. The study group used nursing interventions based on prone position ventilation. Blood gas analysis indexes and hemodynamic parameters of the two groups were observed and recorded before and after treatment. Also, mechanical ventilation time, incidence of ventilator associated pneumonia and incidence of pressure injury were recorded. Results: After 1, 2, and 6 h of mechanical ventilation in the study group, PaCO₂ indexes was lower than that in the control group, and PaO₂, PaO₂/FiO₂ indexes was higher than that of the control group, respectively, and the difference was significant (P<0.05). There were no significant differences in HR, CVP and MAP between the two groups after mechanical ventilation for 1, 2, and 6 h (P>0.05). The time of mechanical ventilation in the study group were lower than that in the control group, and the difference was significant (P<0.05). There was no significant difference in the incidence of ventilator-associated pneumonia and pressure injury between the two groups(P>0.05). Conclusion: Prone position ventilation can effectively improve the oxygenation function of children with NRDS, reduce the time of mechanical ventilation time, and improve the quality of neonatal care.

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