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中华肺部疾病杂志(电子版) ›› 2025, Vol. 18 ›› Issue (05) : 757 -761. doi: 10.3877/cma.j.issn.1674-6902.2025.05.017

论著

新型俯卧位翻身辅助装置在急性呼吸窘迫综合征患者中的临床应用
鲁宇青, 李大伟, 邹剑峰, 胡子龙, 李哲, 李琦, 张丽媛, 霍萌, 沈玥, 帅维正()   
  1. 100048 北京,中国人民解放军总医院第六医学中心重症医学科
  • 收稿日期:2025-03-04 出版日期:2025-10-25
  • 通信作者: 帅维正

Clinical application of the new prone position turning assistance device in patients with acute respiratory distress syndrome

Yuqing Lu, Dawei Li, Jianfeng Zou, Zilong Hu, Zhe Li, Qi Li, Liyuan Zhang, Meng Huo, Yue Shen, Weizheng Shuai()   

  1. Department of Critical Care Medicine, Sixth Medical Center, Chinese People′s Liberation Army General Hospital, Beijing 100048, China
  • Received:2025-03-04 Published:2025-10-25
  • Corresponding author: Weizheng Shuai
引用本文:

鲁宇青, 李大伟, 邹剑峰, 胡子龙, 李哲, 李琦, 张丽媛, 霍萌, 沈玥, 帅维正. 新型俯卧位翻身辅助装置在急性呼吸窘迫综合征患者中的临床应用[J/OL]. 中华肺部疾病杂志(电子版), 2025, 18(05): 757-761.

Yuqing Lu, Dawei Li, Jianfeng Zou, Zilong Hu, Zhe Li, Qi Li, Liyuan Zhang, Meng Huo, Yue Shen, Weizheng Shuai. Clinical application of the new prone position turning assistance device in patients with acute respiratory distress syndrome[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(05): 757-761.

目的

分析新型俯卧位翻身辅助装置在急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)患者中的应用效果,减少传统人力翻身操作所需医护人员数量,降低并发症风险,解决临床人力资源紧缺问题。

方法

选择2021年4月至2022年7月我院收治的29例符合柏林定义ARDS患者,其中重度ARDS患者3例(10.34%),行58次俯卧位通气,自身对照29次人力翻身,29次装置辅助翻身。辅助装置由躯体翻身毯和体位提升装置组成,通过包裹固定患者实现机械辅助翻身。人力翻身采用常规4~5人协作操作。记录操作时间,准备时间T1、翻身时间T2、并发症。计算劳动力系数。

结果

辅助翻身需(3.34±0.48)人少于人力翻身(5.10±0.49)人(P<0.05)。劳动力系数(人力×时间)辅助翻身(1 397.00±341.67) s较人力翻身(1 932.00±365.76)s降低(P<0.05)。辅助翻身方式操作总时间(TT=T1+T2)较长(P<0.05),放置固定毯准备时间T1增加;两种翻身方式实际操作时间T2无差异。人力翻身并发症1例低氧血症+1例胃管脱落;辅助翻身并发症1例压疮+1例胃管脱落,两种翻身方式并发症发生率分别为6.90%(P>0.05)。两种翻身方式生命体征、血气指标及呼吸机参数差异无统计学意义。

结论

新型俯卧位翻身辅助装置可减少翻身操作所需医护人员及总体劳动力消耗,不增加并发症风险,为ICU人力资源紧缺环境下推广俯卧位通气治疗提供了安全,具有临床意义。

Objective

To analyze the clinical efficacy of a novel prone positioning assistive device in patients with acute respiratory distress syndrome (ARDS), aiming to reduce the number of healthcare workers required for traditional manual positioning, decrease complication risks, and address clinical workforce shortages.

Methods

Twenty-nine ARDS patients (severe cases 10.34%) admitted between April 2021 and July 2022 and meeting the Berlin Definition criteria were enrolled. A total of 58 prone positioning sessions were performed, using a self-controlled design, 29 manual turns, 29 device-assisted turns. The assistive device comprised a body-turning blanket and a lifting mechanism to secure and mechanically reposition patients. Manual turns required 4~5 staff members. Operation times (preparation time T1, turning time T2), complications, and workload index (staff number×time) were recorded.

Results

Device-assisted turns required(3.34±0.48) staff members, significantly fewer than manual turns (5.10±0.49)(P<0.05).Workload index was lower in the device-assisted group (1 397.00±341.67) s versus the manual group (1 932.00±365.76) s(P<0.05). Total operation time (TT=T1+ T2) was longer for device-assisted turns (P<0.05), primarily due to increased T1(blanket placement). No difference was observed in T2. Complication rates 6.90% were identical, Manual group: 1 hypoxemia + 1 gastric tube dislodgement. Device-assisted group: 1 pressure ulcer + 1 gastric tube dislodgement (P>0.05). Vital signs, blood gas parameters and ventilator settings showed no significant differences between groups.

Conclusion

The novel prone positioning assistive device significantly reduces healthcare worker requirements and overall workload without increasing complication risks. It offers a safe and efficient solution for promoting prone ventilation therapy in ICU settings facing workforce shortages.

图1 辅助翻身装置示意图。图A为翻身毯;图B为体位提升装置;图C为连接辅助装置的三个固定臂,并形成一个信封状结构;图D为使用提升装置缓慢提升患者
表1 ARDS患者临床资料结果
表2 ARDS患者不同翻身方式俯卧位通气临床指标[M(Q25Q75)]
表3 两种翻身方式俯卧位通气并发症比较[n(%)]
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