摘要
目的:观察俯卧位下密闭式吸痰对改善慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者通气功能及预后情况的影响。方法:选取2021年1月—2023年8月驻马店市中心医院收治的90例COPD患者作为研究对象。采用随机数表法将入组患者分为常规组和试验组,每组各45例。常规组实施俯卧位下机械通气联合开放式吸痰,试验组实施俯卧位下机械通气联合密闭式吸痰。比较两组患者的炎症反应、血气指标、肺通气功能、血流动力变化情况及预后情况。结果:治疗后,试验组超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)均低于常规组,差异均有统计学意义(t=3.391、3.884、2.203,P<0.05);治疗后,试验组动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))高于常规组,动脉血二氧化碳分压(PaCO_(2))低于常规组,差异均有统计学意义(t=2.266、2.657、3.242,P<0.05);治疗后,试验组第1 s用力呼气容积(FEV1)、最大通气量(MVV)、肺泡通气量(VA)均高于常规组,差异均有统计学意义(t=2.485、2.507、2.604,P<0.05);治疗后,试验组心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)均低于常规组,差异均有统计学意义(t=2.294、3.827、-2.264,P<0.05);治疗后,试验组并发症发生率和Murray评分均低于常规组,差异均有统计学意义(χ^(2)=10.813、t=3.278,P<0.05)。结论:俯卧位机械通气联合封闭吸痰可减轻COPD合并呼吸衰竭患者的气道炎症,改善血气指标、肺通气功能及血流动力学参数,降低并发症发生风险。
Objective:To observe the effect of closed suction of sputum in prone position on improving ventilation function and prognosis in COPD patients with respiratory failure.Methods:90 COPD patients were selected as the study subjects and randomly divided into two groups with 45 cases in each group.The control group received mechanical ventilation in a prone position combined with open sputum suction.The experimental group implemented mechanical ventilation combined with closed suction in a prone position.The inflammatory response,blood gas indicators,lung ventilation function,hemodynamic changes and prognosis of the two groups were compared.Results:After treatment,hs-CRP,PCT and IL-6 of experimental group were lower than those of conventional group,with statistically significant difference(t=3.391,3.884,2.203;P<0.05).After treatment,PaO_(2) and SaO_(2) of test group were higher than those of conventional group,and PaCO_(2) was lower than that of conventional group,with statistically significant difference(t=2.266,2.657,3.242;P<0.05).After treatment,FEV1,MVV and VA of experimental group were higher than those of conventional group,with statistically significant difference(t=2.485,2.507,2.604;P<0.05).HR,MAP and CVP of experimental group were lower than those of conventional group after treatment,with statistically significant difference(t=2.294,3.827,-2.264;P<0.05).The complication rate of experimental group was lower than that of conventional group,and Murray score was also lower than that of conventional group,with statistically significant difference(χ^(2)=10.813,t=3.278;P<0.05).Conclusion:The combination of prone position mechanical ventilation and closed suction can alleviate airway inflammation in COPD patients with respiratory failure;improve blood gas indicators,lung ventilation function and hemodynamic parameters;and reduce the risk of complications.
作者
董璐璐
姚丽杰
Dong Lulu;Yao Lijie(Department of Respiratory Intensive Care Medicine,Zhumadian Central Hospital,Zhumadian,Henan,463000,China)
出处
《黑龙江医学》
2025年第14期1667-1670,共4页
Heilongjiang Medical Journal
基金
河南省医学教育研究项目(Wjlx202101322)。
关键词
慢性阻塞性肺疾病
呼吸衰竭
俯卧位下机械通气
密闭式吸痰
预后情况
Chronic obstructive pulmonary disease
Respiratory failure
Mechanical ventilation in prone position
Closed suction of phlegm
Prognostic situation
