俯卧位通气在PICU呼吸机相关性肺炎患儿中的应用效果

doi:10.20047/j.issn1673-7210.2023.28.26

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摘要目的分析俯卧位通气在儿童重症监护室（PICU）呼吸机相关性肺炎患儿中的应用效果。方法 120例研究对象选取温州医科大学附属第二医院2020年12月至2022年7月PICU收治的患儿，使用机械通气的时间前后顺序交替分为研究组（60例）和试验组（60例）。2～3 h对体位进行一次改变，对照组进行仰卧位、侧卧位交替体位，试验组进行仰卧位、侧卧位、俯卧位交替体位。检测比较两组并发症发生情况、肺功能、炎症因子水平及临床疗效。结果治疗后，试验组患儿最大通气量、第1秒用力呼气量、用力肺活量、最大呼气流量水平高于对照组，差异有统计学意义（P＜0.05）。试验组转化生长因子-β1、白细胞介素-6、高迁移率族蛋白B1、肿瘤坏死因子-α水平低于对照组，差异有统计学意义（P＜0.05）。试验组并发症总发生率低于对照组，差异有统计学意义（P＜0.05）。试验组治疗总有效率高于对照组，差异有统计学意义（P＜0.05）。结论 PICU采用俯卧位通气后呼吸机相关性肺炎发生率降低，肺功能改善，炎症反应减轻，症状缓解。

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	林凌洁　　张丹如　　董苗苗

关键词 ：儿科重症监护病房, 俯卧位通气, 呼吸机相关性肺炎, 肺功能

Abstract：Objective To analyze the effect of prone position ventilation in children with ventilator-associated pneumonia in pediatric intensive care unit (PICU). Methods A total of 120 children with PICU admitted to the Second Affiliated Hospital of Wenzhou Medical University from December 2020 to July 2022 were selected. They were divided into study group (60 cases) and experimental group (60 cases) in alternating order of using mechanical ventilation. The body position was changed every two to three hours, the control group was replaced by supine position and side position, while the experimental group was replaced by supine position, side position and prone position. The incidence of complications, lung function, levels of inflammatory factors, and clinical efficacy of two groups were detected and compared. Results After treatment, the maximum volume of air, forced expiratory volume in one second, forced vital capacity, and maximum expiratory flow in experimental group were higher than those in control group, and the differences were statistically significant (P＜0.05). The levels of transforming growth factor-β1, interleukin-6, high mobility group protein box1, and tumor necrosis factor-α in experimental group were lower than those in control group, and the differences were statistically significant (P＜0.05). The total complication rate in experimental group was lower than that in control group, and the difference was statistically significant (P＜0.05). The total effective rate of treatment in experimental group was higher than that in control group, and the difference was statistically significant (P＜0.05). Conclusion After prone position ventilation in PICU, the incidence of ventilator-associated pneumonia is reduced, lung function is improved, inflammation is alleviated, and symptoms are relieved.

Key words： Pediatric intensive care unit Prone position ventilation Ventilator-associated pneumonia Lung function

基金资助:浙江省温州市科研项目（Y2020639）。

引用本文:

林凌洁　　张丹如　　董苗苗. 俯卧位通气在PICU呼吸机相关性肺炎患儿中的应用效果[J]. 中国医药导报, 2023, 20(28): 119-122.
LIN Lingjie ZHANG Danru DONG Miaomiao. Effect of prone position ventilation in children with PICU ventilator-associated pneumonia#br#. 中国医药导报, 2023, 20(28): 119-122.

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https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.28.26 或 https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I28/119