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俯卧位下肺保护性通气策略护理在肺癌根治术中的应用

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目的:观察俯卧位下的肺保护性通气策略护理在肺癌根治术中的应用效果.方法:选取2020年5月—2023年1月郑州大学第一附属医院期间收治的100例肺癌患者作为研究对象,采用随机数表法将患者分为常规组和试验组,每组各50例.所有患者均接受肺癌根治术治疗,常规组采用常规体位下肺保护性通气策略辅助手术,试验组采用俯卧位下肺保护性通气策略辅助手术.比较两组患者的治疗情况,呼吸机相关参数、氧合功能改善情况及治疗后的肺功能损伤情况.结果:试验组患者的吸氧时间、单肺通气时间、术后麻醉恢复室停留时间及最终住院时间均短于常规组,差异有统计学意义(t=3.076、1.211、3.978、4.138,P<0.05);在不同通气策略下,试验组患者的术中呼气末正压、平台压均高于常规组,驱动压低于常规组,差异有统计学意义(t=2.993、2.883、3.006,P<0.05);在不同通气策略下,试验组T1、T2时的血氧饱和度SaO2、氧合指数均高于常规组,差异有统计学意义(t=3.087、3.377、4.167、2.876,P<0.05);在不同通气策略下,试验组患者术后肺顺应性高于常规组,肺部炎症及肺通气功能障碍发生率均低于常规组,差异具有统计学意义(t=2.379;x2=5.980、6.945,P<0.05).结论:俯卧位下的肺保护性通气护理能加快肺癌患者术后康复进程,对改善呼吸机相关参数、氧合功能、避免肺功能损伤均有积极意义.
Application of Protective Ventilation Strategy Nursing in Prone Position for Lung Cancer Radical Surgery
Objective:To observe the application effect of lung protective ventilation strategy nursing in prone position in radical lung cancer surgery.Methods:Conducting prospective study on 100 lung cancer patients admitted to the First Affiliated Hospital of Zhengzhou University from May 2020 to January 2023.The patients were divided into conventional group and experimental group with computer random number table method,with 50 cases in each group.All patients underwent radical surgery for lung cancer.The conventional group used conventional posture lung protective ventilation strategy as an auxiliary surgery,while the experimental group used prone posture lung protective ventilation strategy as an auxiliary surgery.The treatment status,ventilator related parameters,improvement of oxygenation function,and lung function damage after treatment between the two groups of patients were compared.Results:The oxygen inhalation time,single lung ventilation time,PACU residence time and final hospital stay of experimental groups were lower than those of conventional group,with statistically significant difference(t=3.076,1.211,3.978,4.138;P<0.05).Under different ventilation strategies,the intraoperative positive expiratory pressure and plateau pressure of experimental group were higher than those of conventional group,and the driving pressure was lower than that of conventional group,with statistically significant difference(t=2.993,2.883,3.006;P<0.05).Under different ventilation strategies,SaO2 and P/F in experimental groups at T1 and T2 were higher than those in conventional group,and the differences were statistically significant(t=3.087,3.377,4.167,2.876;P<0.05).Under different ventilation strategies,the postoperative CL of experimental group was higher than that of conventional group,and the incidence of pulmonary inflammation and pulmonary ventilation dysfunction were lower than that of conventional group,with statistically significant difference(t=2.379;x2=5.980,6.945;P<0.05).Conclusion:Lung protective ventilation nursing in prone position can accelerate the postoperative recovery process of lung cancer patients;improve ventilator related parameters and oxygenation function;and avoid lung function damage.

Radical resection of lung cancerLung protective ventilation strategyPositional careLung function injuryPrognostic situation

薛婷婷、陈咪

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郑州大学第一附属医院呼吸内科,河南 郑州 450000

肺癌根治术 肺保护性通气策略 体位护理 肺功能损伤 预后情况

2024

黑龙江医学
中华医学会黑龙江分会

黑龙江医学

影响因子:0.714
ISSN:1004-5775
年,卷(期):2024.48(20)