目的 探讨渐进式肌肉放松训练在急性呼吸窘迫综合征（acute respiratory distress syndrome,ARDS）患者清醒俯卧位通气中的实施效果。方法 采用类实验研究法,选取2023年5月—7月湖南省某三级甲等医院ARDS患者45例为试验组,清醒俯卧位通气前采用渐进式肌肉放松训练方案;2022年12月—2023年2月的ARDS患者45例为对照组,采用常规清醒俯卧位通气。比较两组患者清醒俯卧位通气治疗前3 d内的每日单次治疗最长时间、治疗总时长、耐受性和治疗效果。结果 试验组在清醒俯卧位通气第3天的单次治疗最长时间[（3.68±0.71） h]高于对照组[（2.50±0.67） h],试验组前3 d治疗总时长[（36.72±0.56） h]高于对照组[（23.25±1.76） h]（P<0.001）;试验组在治疗第3天的耐受性指标（视觉模拟评分）[（2.83±1.74）分]小于对照组[（6.17±1.11）分] （P<0.001）;试验组在俯卧位治疗开始4 h后的血氧分压及氧合指数均优于对照组（P<0.001）。结论 渐进式肌肉放松训练能有效延长ARDS患者清醒俯卧位通气的治疗时间,提高耐受性,从而改善治疗效果。
Objective To investigate the effect of progressive muscle relaxation training in awake prone ventilation in patients with acute respiratory distress syndrome（ARDS）. Methods The quasi-experiment research method was used. 45 ARDS patients in a tertiary hospital in Hunan Province from May to July 2023 were selected as the experimental group,and the progressive muscle relaxation training program was used before prone ventilation. 45 ARDS patients from December 2022 to February 2023 were selected as the control group,and traditional prone-position ventilation was used. The maximum duration of a single daily treatment and the total duration of treatment in the first 3 days of prone position ventilation,tolerance,and the effect of treatment were compared between the two groups. Results The maximum duration of a single daily treatment[（3.68±0.71） h] of experimental group in the third day of awake prone ventilation was higher than that of control group[（2.50±0.67） h],and the total duration of treatment[（36.72±0.56） h] in the first 3 days of experimental group was higher than that of control group [（23.25±1.76） h]（P<0.001）. The tolerance index（Visual Analogue Score-VAS）[（2.83±1.74） points] of experimental group was lower than that of control group[（6.17±1.11） points] on day 3 of treatment（P<0.001）. The blood oxygen partial pressure and oxygenation index of experimental group were better than those of control group 4 h after prone position treatment（P<0.001）. Conclusion Progressive muscle relaxation training can effectively prolong the ventilation treatment time of awake prone position in ARDS patients,improve tolerance,and thus improve the therapeutic effect.
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