海绵水囊套枕在清醒俯卧位通气患者中的应用OA
Application of sponge water pillow casing in awake prone positioning ventilation patients
目的 探讨专利产品海绵水囊套枕在清醒俯卧位通气(APP)患者中的应用效果.方法 选择2023年12月至2024年10月杭州市第一人民医院重症医学科收治的60例急性低氧性呼吸衰竭(AHRF)患者作为研究对象,按随机数字表法将患者分为观察组和对照组,每组30例.对照组有3例患者中途退出,最终27例患者纳入分析.行 APP 时观察组患者使用海绵水囊套枕,对照组患者使用棉花芯软枕.比较两组行 APP 3 d俯卧位总时长、脉搏血氧饱和度(SpO2)、动脉血氧分压(PaO2)、压力性损伤发生部位及损伤程度、整体舒适度、治疗依从性的差异.结果 观察组 3 d 累计俯卧位总时长较对照组明显延长(h:43.26±4.95 比 28.48±5.49,P＜0.01).观察组的整体舒适度评分、治疗依从性评分为 2 分的患者比例、胸部的压力性损伤发生率、Ⅰ度压力性损伤发生率均明显低于对照组[整体舒适度评分(分):3.13±1.19 比 5.63±1.94,治疗依从性评分为 2 分患者比例:10.0%(3/30)比 63.0%(17/27),胸部的压力性损伤发生率:6.7%(2/30)比 29.6%(8/27),Ⅰ度损伤发生率:10.0%(3/30)比 48.1%(13/27),均 P＜0.05];观察组治疗依从性评分为 3 分和 4 分患者的比例均明显高于对照组[治疗依从性评分为 3 分患者比例:53.3%(16/30)比 18.5%(5/27),治疗依从性评分为 4 分患者比例,36.7%(11/30)比 7.4%(2/27),均 P＜0.05].结论 行 APP 时采用海绵水囊套枕可提升患者的整体舒适度,增加患者俯卧位依从性,进而延长患者俯卧位时长,降低患者俯卧位过程中胸部压力性损伤发生率及Ⅰ度压力性损伤发生率,以及患者插管率及死亡风险,减少并发症.
Objective To explore the application effect of a sponge water pillow casing in patients undergoing awake prone positioning(APP)ventilation.Methods A total of 60 patients with acute hypoxemic respiratory failure(AHRF)admitted to the department of critical care medicine of Hangzhou First People's Hospital from December 2023 to October 2024 were enrolled as research subjects.The patients were randomly divided into the observation group and the control group using the random number table method,with 30 cases in each group.Three patients in the control group dropped out of the study midway,finally,27 patients were included in the analysis.Patients in the observation group were provided with the sponge water pillow casing,while those in the control group used cotton-core soft pillows.The two groups were compared in terms of the cumulative 3-day APP,pulse oxygen saturation(SpO2),arterial partial pressure of oxygen(PaO2),location and severity of pressure injuries,overall comfort,and treatment compliance.Results The cumulative 3-day prone position duration in the observation group was significantly longer than that in the control group(hours:43.26±4.95 vs.28.48±5.49).The observation group had notably lower overall comfort scores,proportion of patients with a treatment compliance score of 2 points,incidence of thoracic pressure injuries,and incidence of stageⅠpressure injuries than the control group[overall comfort score:3.13±1.19 vs.5.63±1.94;proportion of patients with 2-point compliance score:10.0%(3/30)vs.63.0%(17/27);incidence of thoracic pressure injuries:6.7%(2/30)vs.29.6%(8/27);incidence of stageⅠpressure injuries:10.0%(3/30)vs.48.1%(13/27),all P<0.05];the proportions of patients with treatment compliance scores of 3 points and 4 points in the observation group were significantly higher[proportion of 3-point compliance score:53.3%(16/30)vs.18.5%(5/27);proportion of 4-point compliance score:36.7%(11/30)vs.7.4%(2/27),both P<0.05].Conclusions The application of sponge water pillow casing can improve patients'overall comfort and prone position compliance,thereby prolonging prone position duration,reducing the incidence of pressure injuries and stageⅠpressure injuries during prone positioning,lowering the intubation rate and mortality risk,and minimizing the occurrence of complications.
晏俊华;夏柳勤;王帅;章敏飞;胡玲琳;罗蒙强
浙江中医药大学,浙江 杭州 310053||杭州市第一人民医院重症医学科,浙江 杭州 310006杭州市第一人民医院重症医学科,浙江 杭州 310006杭州市第一人民医院重症医学科,浙江 杭州 310006杭州市第一人民医院重症医学科,浙江 杭州 310006杭州市第一人民医院重症医学科,浙江 杭州 310006杭州市第一人民医院重症医学科,浙江 杭州 310006
海绵水囊套枕清醒俯卧位通气俯卧位时长依从性压力性损伤
Sponge water pillow casingAwake prone positioning ventilationProne positioning durationCompliancePressure injury
《中国中西医结合急救杂志》 2026 (2)
193-198,6
浙江省杭州市医药卫生科技项目(A20220551)国家实用新型专利(ZL 2021 2 0821792.4,ZL 2021 2 0820673.7,ZL 2021 2 0826578.8,ZL 2021 2 0820649.3,ZL 2021 2 0827002.3) Hangzhou Medical and Health Science and Technology Project,Zhejiang Province(A20220551)National Utility Model Patent of China(ZL 2021 2 0821792.4,ZL 2021 2 0820673.7,ZL 2021 2 0826578.8,ZL 2021 2 0820649.3,ZL 2021 2 0827002.3)
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