[1]叶梅真,吴碧瑜,刘春芳,等.无创呼吸机PEEP参数设置在重症急性胰腺炎患者俯卧位机械通气中的应用[J].中国医学物理学杂志,2023,40(11):1418-1422.[doi:DOI:10.3969/j.issn.1005-202X.2023.11.016]
　YE Meizhen,WU Biyu,LIU Chunfang,et al.PEEP parameter setting of non-invasive ventilator for prone position mechanical ventilation in patients with severe acute pancreatitis[J].Chinese Journal of Medical Physics,2023,40(11):1418-1422.[doi:DOI:10.3969/j.issn.1005-202X.2023.11.016]
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无创呼吸机PEEP参数设置在重症急性胰腺炎患者俯卧位机械通气中的应用()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
40卷
期数:
2023年第11期
页码:
1418-1422
栏目:
医学生物物理
出版日期:
2023-11-24

文章信息/Info

Title:
PEEP parameter setting of non-invasive ventilator for prone position mechanical ventilation in patients with severe acute pancreatitis
文章编号:
1005-202X（2023）11-1418-05
作者:
叶梅真1; 吴碧瑜2; 刘春芳1; 邱燕燕3; 李颖怡1
1.泉州市第一医院（福建医科大学附属泉州第一医院）消化内科， 福建 泉州 362000； 2.泉州市第一医院（福建医科大学附属泉州第一医院）护理部， 福建 泉州 362000； 3.泉州市第一医院（福建医科大学附属泉州第一医院）感染科， 福建 泉州 362000
Author(s):
YE Meizhen1;  WU Biyu2;  LIU Chunfang1;  QIU Yanyan3;  LI Yingyi1
1. Department of Gastroenterology, Quanzhou First Hospital (Quanzhou First Hospital Affiliated to Fujian Medical University), Quanzhou 362000, China 2. Department of Nursing, Quanzhou First Hospital (Quanzhou First Hospital Affiliated to Fujian Medical University), Quanzhou 362000, China 3. Department of Infectious Diseases, Quanzhou First Hospital (Quanzhou First Hospital Affiliated to Fujian Medical University), Quanzhou 362000, China
关键词:
重症急性胰腺炎; 机械通气; 无创呼吸机; 呼吸末正压通气; 俯卧位
Keywords:
Keywords: severe acute pancreatitis mechanical ventilation non-invasive ventilator positive end-expiratory pressure prone position
分类号:
R563.8
DOI:
DOI:10.3969/j.issn.1005-202X.2023.11.016
文献标志码:
A
摘要:
目的：探讨无创呼吸机呼吸末正压通气（PEEP）参数设置在重症急性胰腺炎（SAP）患者俯卧位机械通气中的应用。方法：选取泉州市第一医院120例SAP患者，根据随机数字表法分为两组，各60例。两组均行无创呼吸机俯卧位机械通气，观察组为PEEP≥10 cmH2O，对照组为PEEP≤5 cmH2O，比较两组并发症发生率、病死率、机械通气、入住ICU及住院时间、治疗前及治疗后72 h每分钟通气量、动脉血氧分压（PaO2）、心率（HR）、呼吸频率、动脉血二氧化碳分压（PaCO2）、气道闭合压及气道峰值、pH值、平均动脉压（MAP）、CT严重程度指数（CTSI）、急性生理与慢性健康状况评分系统Ⅱ（APACHE-Ⅱ）评分。结果：观察组每分钟通气量、呼吸频率、PaO2高于对照组，气道闭合压、气道峰值、PaCO2、CTSI评分、APACHE-Ⅱ评分低于对照组（P<0.05）；两组治疗前后MAP、HR比较，差异无统计学意义（P>0.05）；观察组机械通气、入住ICU及住院时间均短于对照组（P<0.05）；观察组出院90 d病死率低于对照组（P<0.05）。结论：无创呼吸机俯卧位机械通气期间PEEP≥10 cmH2O治疗SAP患者，可有效改善肺内氧合，有助于缩短治疗及康复时间，改善患者预后。
Abstract:
Abstract: Objective To investigate the effect of non-invasive positive end-expiratory pressure (PEEP) on prone position mechanical ventilation in patients with severe acute pancreatitis (SAP). Methods A total of 120 SAP patients in Quanzhou First Hospital were enrolled. The patients were mechanically ventilated using non-invasive ventilator in prone position, with PEEP≥10 cmH2O in observation group (n=60) and PEEP≤5 cmH2O in control group (n=60). The two groups were compared in terms of incidence of complications, mortality rate, mechanical ventilation, ICU stay and hospital stay, ventilation per minute before and at 72 h after treatment, arterial partial pressure of oxygen (PaO2), heart rate (HR), respiratory rate, arterial partial pressure of carbon dioxide (PaCO2), airway closure pressure and peak airway pressure, pH, mean arterial pressure (MAP), CT severity index (CTSI), and acute physiology and chronic health evaluation scoring system II (APACHE-II) score. Results Compared with control group, observation group had higher ventilation per minute, respiratory rate and PaO2, and lower airway closure pressure, peak airway pressure, PaCO2, CTSI score and APACHE-II score (P<0.05). There was no statistically significant difference in MAP and HR between two groups before and after treatment (P>0.05). Mechanical ventilation, ICU stay, and hospital stay in observation group were shorter than those of control group (P<0.05). The 90-d mortality rate was lower in observation group than in control group (P<0.05). Conclusion Non-invasive prone position mechanical ventilation with PEEP≥10 cmH2O for SAP effectively improves intrapulmonary oxygenation, contributes to a shorter treatment and rehabilitation, and improves patient prognosis.

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备注/Memo

备注/Memo:
【收稿日期】2023-07-12 【基金项目】福建省自然科学基金（2020J011282） 【作者简介】叶梅真，副主任护师，研究方向：消化内科护理，E-mail: longts87118@163.com 【通信作者】李颖怡，主治医师，研究方向：高脂血症性胰腺炎，E-mail: liyingyi0924@126.com
更新日期/Last Update: 2023-11-24