Study on stepped pulmonary rehabilitation nursing in patients with severe acute respiratory distress syndrome
阶梯式肺康复护理在重症急性呼吸窘迫综合征患者中的研究

摘要

目的 探讨在重症急性呼吸窘迫综合征（ARDS）患者中实施阶梯式的肺康复护理方法的实践价值。方法 选取2023年4月至2024年4月本院ICU收治的70例ARDS患者，根据奇偶数法将其随机分组，对照组（常规肺康复护理，35例），观察组（阶梯式肺康复护理，35例）。对比两组护理前后血气指标（动脉血氧分压/PaO2、动脉血二氧化碳分压/PaCO2），记录且对比两组的治疗及康复时间（机械通气、ICU住院、总住院）和并发症风险。结果 护理后观察组的PaO2高于对照组，PaCO2低于对照组，且机械通气、ICU住院、总住院的时间均短于对照组，患者并发症（胸腔积液、肺部感染、气压伤）总发生率低于对照组（P＜0.05）。结论 对重症ARDS患者采取阶梯式的肺康复护理措施能改善其机械通气指标，缩短康复进程，并降低并发症发生率，值得临床推广。

Abstract

Objective To explore the practical value of the stepped pulmonary rehabilitation nursing in patients with severe acute respiratory distress syndrome (ARDS).
Methods Seventy patients with ARDS admitted to ICU of our hospital from April 2023 to April 2024 were selected and randomly divided into control group (conventional pulmonary rehabilitation nursing, 35 cases) and observation group (stepped pulmonary rehabilitation nursing, 35 cases) according to the odd-even method. Blood gas indexes (arterial partial pressure of oxygen /PaO2, arterial partial pressure of carbon dioxide /PaCO2) before and after care were compared between the two groups, and the treatment and recovery time (mechanical ventilation, ICU hospitalization, total hospitalization) and complication risk were recorded and compared between the two groups.
Results After nursing, the PaO2 and PaCO2 in the observation group were higher than those in the control group, and the duration of mechanical ventilation, ICU hospitalization and total hospitalization were shorter than those in the control group, and the total incidence of complications (pleural effusion, pulmonary infection and barotrauma) was lower than that in the control group (P < 0.05).
Conclusion   The stepped pulmonary rehabilitation nursing measures for patients with severe ARDS can improve their lung function, shorten the rehabilitation process, and reduce the incidence of complications, which is worthy of clinical promotion.