摘要
目的 探讨针对性护理应用在采取ECMO联合俯卧位通气治疗的重症肺炎（SAP）中的效果。方法 采用回顾性研究方法，选择院内就诊的106例ECMO+俯卧位通气治疗的SAP患者（样本纳入例数：106例；样本纳入时间：2022年1月至2023年12月），以随机摸球为基础分组方式，分为对照、观察两个小组，观察例数高度一致。分别实施常规护理，针对性护理。各53例，对比效果。结果 观察组肺功能（FEV1/FVC/PEFR）、并发症（低血压/栓塞/感染/凝血与出血）发生率、症状（发热/喘促/咳痰/咳嗽）缓解时间、生活质量（情绪功能/角色功能/认知功能/躯体功能）评分优于对照组（P<0.05）。结论 ECMO联合俯卧位通气在对SAP治疗期间配合针对性护理存在显著效果，在改善肺功能、生活质量中意义重大，值得应用。
关键词： 重症肺炎；ECMO；并发症；俯卧位通气；肺功能；生活质量；针对性护理
Abstract
Objective To investigate the effect of targeted nursing application in severe pneumonia (SAP) treated with ECMO combined with prone ventilation. Methods Using a retrospective study method, 106 SAP patients treated with ECMO and prone ventilation in the hospital were selected (sample number: 106; sample inclusion period: January 2022 to December 2023). They were randomly divided into control and observation groups based on ball touching, with a highly consistent number of observation cases. Implement routine care and targeted care separately. 53 cases each, compare the effects. Results The observation group had better scores in lung function (FEV1/FVC/PEFR), incidence of complications (hypotension/embolism/infection/coagulation and bleeding), symptom relief time (fever/wheezing/sputum/cough), and quality of life (emotional function/role function/cognitive function/physical function) compared to the control group (P<0.05). Conclusion ECMO combined with prone ventilation has a significant effect on the treatment of SAP with targeted nursing, which is of great significance in improving lung function and quality of life, and is worthy of application.
Key words： Severe pneumonia; ECMO; Complication; Prone ventilation; Lung function; Quality of life; Targeted care
参考文献 References
[1] 郑丽,牟春英,黎巧玲. 1例重症肺炎患者体外膜肺氧合联合连续性肾脏替代及机械通气治疗的康复护理[J]. 现代临床护理,2021,20(9):81-85.
[2] 曹丽,胡露红,韩秀娟,等. V-VECMO联合CRRT及机械通气治疗危重型新型冠状病毒肺炎的临床护理[J]. 当代护士（上旬刊）,2021,28(2):145-149.
[3] 汪利萍,潘向滢,罗松娜,等. 1例危重型新型冠状病毒肺炎患者应用体外膜肺氧合联合早期康复锻炼护理[J]. 加速康复外科杂志,2022,5(2):88-91.
[4] 刘璇,戴晴霞,刘奇玉,等. 1例新型冠状病毒肺炎后纤维化患者双肺联合移植术后谵妄发生的原因分析及护理[J]. 当代护士（上旬刊）,2021,28(7):168-170.
[5] 朱豫,戴晓婧,华莎,等. 3例危重症型冠状病毒肺炎患者应用体外膜肺氧合联合俯卧位通气的护理[J]. 解放军护理杂志,2020,37(4):90-92.
[6] 张银英,廖小卒,张露,等. 应用体外膜肺氧合联合机械通气的危重症新型冠状病毒肺炎患者院内转运的安全管理[J]. 中西医结合护理（中英文）,2020,6(3):196-198.
[7] 徐前程,姜小敢,王涛,等. 新型冠状病毒肺炎疫情期间ECMO院际转运流程探讨：基于6例重症甲型H1N1流感病毒性肺炎ECMO转运经验的提示[J]. 中华危重病急救医学,2020,32(4):430-434.
[8] 朱丽,李云,奚慧琴,等. 1例新型冠状病毒肺炎危重型患者行体外膜氧合治疗中的气道管理[J]. 上海交通大学学报（医学版）,2021,41(3):406-408.
[9] 靳英辉,詹庆元,彭志勇,等. 新型冠状病毒肺炎药物预防、诊断、治疗与出院管理循证临床实践指南（更新版）[J]. 解放军医学杂志,2020,45(10):1003-1031.
[10] 尚学园,王左朋,李百强,等. 危重型新型冠状病毒肺炎患者的整体护理体会——附48例报告[J]. 东方药膳,2020(19):253-254.