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改良式翻身护理对烧伤合并重度吸入性损伤患者肺部感染转归的影响
Effect of Modified Body Turning on the Progression of Pulmonary Infection for Burn Patients Combined with Severe Inhalation Injury

刘红芳.改良式翻身护理对烧伤合并重度吸入性损伤患者肺部感染转归的影响[J].中国烧伤创疡杂志,2020,(1):38~42.

DOI：

中文关键词: 改良式翻身护理左右侧卧位交替翻身护理烧伤吸入性损伤肺部感染转归影响

英文关键词:Modified body turning Left and right lateral decubitus position alternating body turning Burns Inhalation injury Pulmonary infection Progression Influence

基金项目:

作者	单位
刘红芳	长沙医学院附属株洲市人民医院

摘要点击次数: 2014

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中文摘要:

【摘要】目的研究探讨改良式翻身护理对烧伤合并重度吸入性损伤患者肺部感染转归的影响。方法选取2016年5月至2019年5月长沙医学院附属株洲市人民医院重症医学科收治的35例烧伤合并重度吸入性损伤患者作为研究对象，并按照随机数表法将其随机分为治疗组（18例）与对照组（17例），其中治疗组患者采用改良式翻身法予以护理，对照组患者采用左右侧卧位交替翻身法予以护理，对比观察两组患者机械通气时间以及治疗前与治疗第3、5、7、14天时的血清降钙素原（PCT）水平、C反应蛋白（CRP）水平、白细胞（WBC）计数及临床肺部感染评分（clinical pulmonary infection score，CPIS）。结果治疗组患者的机械通气时间为（7.35±1.38）d，明显短于对照组患者的机械通气时间（8.88±1.87）d，差异具有统计学意义（t=2.485，P=0.020）。治疗第3天，两组患者PCT水平、CRP水平、WBC计数及CPIS对比，差异均无统计学意义（t=1.925、0.171、0.957、0.595，P=0.065、0.866、0.348、0.557）；治疗第5天，治疗组患者除WBC计数与对照组无明显差异（t=1.063，P=0.298）外，PCT水平、CRP水平及CPIS均明显低于对照组，差异具有统计学意义（t=2.135、2.145、2.231，P=0.042、0.042、0.035）；治疗第7天，治疗组患者除PCT水平与对照组无明显差异（t=0.729，P=0.472）外，CRP水平、WBC计数及CPIS均明显低于对照组，差异具有统计学意义（t=2.285、2.222、2.067，P=0.031、0.035、0.049）；治疗第14天，治疗组患者除CPIS明显低于对照组，差异具有统计学意义（t=2.082，P=0.047）外，PCT水平、CRP水平及WBC计数均与对照组无明显差异（t=0.454、0.965、1.844，P=0.654、0.343、0.077）。结论与左右侧卧位交替翻身护理相比，改良式翻身护理可有效减轻烧伤合并重度吸入性损伤患者的肺部感染症状，缩短机械通气时间，促进肺部感染痊愈，值得临床推广应用。

英文摘要:

【Abstract】Objective To investigate the effect of modified body turning on the progression of pulmonary infection for burn patients combined with severe inhalation injury. Methods 35 burn patients combined with severe inhalation injury, admitted to Intensive Care Unit, Zhuzhou People’s Hospital Affiliated to Changsha Medical University from May 2016 to May 2019, were selected as subjects and then divided, according to random number table, into a treatment group (18 cases) and a control group (17 cases). The patients in the treatment group received modified body turning care and the patients in the control group got left and right lateral?decubitus?position?alternating body turning. The mechanical ventilation time, serum procalcitonin (PCT) level, C-reactive protein (CRP) level, white blood cell (WBC) count and clinical pulmonary infection score (CPIS) on day 3, 5, 7 and 14 after treatment were analyzed and compared. Results The mechanical ventilation time for the treatment group was (7.35±1.38)d, significantly shorter than that of the control group (8.88±1.87)d and the results of comparison (t=2.485, P=0.020) showed statistically significant difference. On day 3, the PCT level, CRP level, WBC count and CPIS were compared between the two groups and the results of comparison (t=1.925, 0.171, 0.957, 0.595, P=0.065, 0.866, 0.348, 0.557) showed no statistically significant difference; On day 5, no significant difference was observed in WBC count between the treatment group and control group (t=1.063, P=0.298), but the PCT level, CRP level and CPIS of the treatment group were much lower than that of the control group and the results of comparison showed statistically significant difference (t= 2.135, 2.145, 2.231, P=0.042, 0.042, 0.035);On day 7, no significant difference was observed in PCT level between the treatment group and the control group (t=0.729, P=0.472), but the CRP level, WBC count and CPIS of the treatment group were much lower than that of the control group, and the results of comparison (t= 2.285, 2.222, 2.067, P=0.031, 0.035, 0.049) showed statistically significant difference; On day 14, the CPIS of the treatment group was much lower than that of the control group (t=2.082, P=0.047) and the results of comparison showed （t=2.082，P=0.047） statistically significant difference, but no significant difference was observed in PCT level, CRP level and WBC count (t= 0.454, 0.965, 1.844, P=0.654, 0.343, 0.077). Conclusion Compared with left and right lateral?decubitus?position?alternating body turning , modified body turning can alleviate the symptoms of pulmonary infection for burn patients combined with severe inhalation injury, shorten their mechanical ventilation time, and promote the recovery of pulmonary infection, so it deserves to be promoted in clinical practice.