Discussion on the value of early awake body position therapy in the respiratory treatmentof patients with severe new coronary pneumonia
早期清醒体位治疗在重症新冠肺炎患者呼吸治疗中的价值探讨

摘要

目的 探讨早期施行清醒体位治疗在重症新冠肺炎患者呼吸治疗中的临床价值。方法 选取2020年1月底至2020年3月初在益阳市第四人民医院和麻城市人民医院集中收治的20例重型和危重型新冠肺炎患者，观察组转入ICU后根据CT表现即实施俯卧位或侧卧位通气，对照组实施常规治疗，对比相关指标。结果 观察组体位治疗后48h、72h的氧合指数均显著高于对照组，3d后的肺部超声失充气评分和5天后的肺部CT改善情况均好于对照组，同时观察组的插管率、28天病死率均明显小于对照组，机械通气时间也明显缩短，P＜0.05。结论 早期清醒体位治疗能改善重症新冠肺炎患者重力依赖区的肺泡通气，从而改善氧合和肺部病灶，延缓病情进一步进展，具有重要的治疗价值。

Abstract

Objective To explore the clinical value of early awake body position therapy in the respiratory treatment of patients with severe new coronary pneumonia.
Methods Twenty patients with severe and critical new coronary pneumonia who were centrally treated in Yiyang Fourth People's Hospital and Macheng People's Hospital from the end of January 2020 to the beginning of March 2020 were selected. Ventilation in lateral position, the control group was given routine treatment, and related indicators were compared.
Results The oxygenation index of the observation group was significantly higher than that of the control group at 48h and 72h after postural treatment. The lung ultrasound deflator score after 3 days and the improvement of lung CT after 5 days were better than those of the control group. The 28-day mortality rate and the 28-day mortality rate were significantly lower than those of the control group, and the mechanical ventilation time was also significantly shortened, P<0.05.
Conclusion   Early awake body position therapy can improve alveolar ventilation in the gravity-dependent area of patients with severe new coronary pneumonia, thereby improving oxygenation and pulmonary lesions, and delaying the further progression of the disease, which has important therapeutic value.