俯卧位通气对重症肺炎患者谵妄的影响研究
Effects of Prone Position Ventilation on Delirium in Patients with Severe Pneumonia
邱瑾 1袁啸晟 2许莉莉 3阮正上 4杨智清 2戈晓华5
作者信息
- 1. 上海交通大学 护理学院,上海 200025;上海交通大学医学院附属新华医院 麻醉与重症医学科,上海 200092
- 2. 上海交通大学医学院附属新华医院 麻醉与重症医学科,上海 200092
- 3. 上海交通大学医学院附属新华医院 儿急危重症医学科
- 4. 上海交通大学医学院附属新华医院 感染科
- 5. 上海交通大学医学院附属新华医院 护理部
- 折叠
摘要
目的 探讨俯卧位通气对重症肺炎患者发生谵妄的影响.方法 回顾性分析 2022 年 12 月至 2023 年 1 月上海市某三级甲等医院监护室收治的 106 名重症肺炎伴低氧血症患者,分为俯卧位通气(prone position ventilation,PPV)组(n=54)和对照组(采用常规仰卧位,n=52),统计两组患者干预前后基础情况、生命体征、实验室检查及并发症情况.结果 行俯卧位通气 3d与 7d后,PPV组的谵妄发生率以及 c反应蛋白、白细胞介素-6、白细胞介质-8 以及肿瘤坏死因子-α等水平均低于对照组(均P＜0.05);PPV组氧合指数呈上升趋势,炎症因子总体呈下降趋势,且两组比较差异均有统计学意义(均P＜0.05).结论 俯卧位通气可能通过抑制炎症和改善氧合情况,来降低重症肺炎患者的谵妄发病率.
Abstract
Objective To explore the effects of prone position ventilation on delirium in patients with se-vere pneumonia and hypoxaemia.Methods Retrospective analysis was used to analyze 106 patients with se-vere pneumonia,who were admitted to the intensive care unit of a tertiary hospital in Shanghai from De-cember 2022 to January 2023.They were divided into a prone position ventilation(PPV)group(n=54)and a control group(in the supine position,n=52).The patients'basic condition,vital signs,laboratory tests,and complications were analyzed.Results After 3 and 7 days of prone position ventilation,the inci-dence of delirium,the level of CRP,IL-6,IL-8 and TNF-αin the PPV group were lower than those of the control group(all P＜0.05).P/F in PPV group showed an increasing trend and the difference between the two groups was statistically significant(all P＜0.05).The overall inflammatory factors in PPV group showed a decreasing trend and the difference between the two groups was statistically significant(all P＜0.05).Conclusions Prone position ventilation may reduce the incidence of delirium in patients with severe pneumonia by inhibiting inflammation and improving oxygenation.
关键词
重症肺炎/俯卧位通气/谵妄/缺氧/炎症因子/护理Key words
severe pneumonia/prone position ventilation/delirium/hypoxia/inflammatory factor/nursing引用本文复制引用
基金项目
上海交通大学医学院护理学科建设项目(SJTU-HLXK2022)
出版年
2024
NETL
NSTL
维普
万方数据