关键词: 超声；胸部物理治疗；机械通气；呼吸治疗；危重症

Abstract: Objective: To explore the application effect of nursing strategy guided by lung ultrasound in respiratory management of patients with mechanical ventilation. Methods: A total of 70 patients with mechanical ventilation in a Critical Care Medicine Department from March 2018 to June 2019 were selected and randomly divided into observation group and control group, with 35 cases in each group. The control group was treated with comprehensive chest physiotherapy, while the observation group was given the nursing strategy of goal-oriented comprehensive chest physiotherapy according to the results of lung ultrasound. Lung ultrasound score, diaphragm function, oxygenation index, vital signs, duration of mechanical ventilation and length of stay in ICU were compared between the two groups. Results: The lung ultrasound scores of the two groups showed a downward trend. Compared with the control group, the lung ultrasound scores in the observation group were significantly lower than those in the control group on the 3rd, 4th and 5th days, and the difference was statistically significant (P<0.05). The diaphragmatic excursion of observation group was higher than that of control group on the 5th day. The diaphragm thickening fraction of observation group was significantly higher than that of control group on the 3rd, 4th and 5th days, and the difference was statistically significant (P<0.05). The oxygenation index of the observation group was significantly higher than that of the control group on the 4th and 5th days, and the difference was statistically significant (P<0.05). The respiratory rate in the observation group was lower than that in the control group on the 3rd, 4th and 5th days, and the Pulse Oxygen Saturation was higher on the 2nd, 3rd, 4th and 5th days, the difference was statistically significant (P<0.05). In terms of duration of mechanical ventilation and length of stay in ICU, the observation group was significantly shorter than the control group, and the difference was statistically significant (P<0.05). There was no statistically difference in heart rate and blood pressure between the two groups. Conclusion: The nursing strategy of comprehensive chest physiotherapy guided by lung ultrasound can improve the lung ventilation, diaphragm function and oxygenation of patients with mechanical ventilation, shorten the duration of mechanical ventilation and the length of stay in ICU.

Key words: ultrasound; chest physiotherapy; mechanical ventilation; respiratory therapy; critical illness