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成人烧伤俯卧位治疗全国专家共识(2022版)

中国老年医学学会烧创伤分会 中华医学会烧伤外科学分会重症学组

中国老年医学学会烧创伤分会,中华医学会烧伤外科学分会重症学组. 成人烧伤俯卧位治疗全国专家共识(2022版)[J]. 中华烧伤与创面修复杂志, 2022, 38(7): 601-609. DOI: 10.3760/cma.j.cn501120-20211208-00407.
引用本文: 中国老年医学学会烧创伤分会,中华医学会烧伤外科学分会重症学组. 成人烧伤俯卧位治疗全国专家共识(2022版)[J]. 中华烧伤与创面修复杂志, 2022, 38(7): 601-609. DOI: 10.3760/cma.j.cn501120-20211208-00407.
The Burn and Trauma Branch of Chinese Geriatrics Society, Critical Care Group of Chinese Burn Association.National expert consensus on prone position therapy in adult burn patients (2022 version)[J].Chin J Burns Wounds,2022,38(7):601-609.DOI: 10.3760/cma.j.cn501120-20211208-00407.
Citation: The Burn and Trauma Branch of Chinese Geriatrics Society, Critical Care Group of Chinese Burn Association.National expert consensus on prone position therapy in adult burn patients (2022 version)[J].Chin J Burns Wounds,2022,38(7):601-609.DOI: 10.3760/cma.j.cn501120-20211208-00407.

成人烧伤俯卧位治疗全国专家共识(2022版)

doi: 10.3760/cma.j.cn501120-20211208-00407
基金项目: 

国家重点研发计划 2019YFA0110601

上海市急危重症临床医学研究中心专项计划 21MC1930400

海军军医大学高等级成果培植计划 2018-CGPZ-B03

详细信息

National expert consensus on prone position therapy in adult burn patients (2022 version)

Funds: 

National Key R&D Program of China 2019YFA0110601

Special Plan of Shanghai Clinical Medical Research Center of Emergency and Critical Care Medicine 21MC1930400

The High-Level Achievement Cultivation Program of Naval Medical University 2018-CGPZ-B03

  • 摘要: 俯卧位通气(PPV)作为机械通气治疗的一部分越来越受重视,相关共识和指南相继出台。俯卧位治疗(PPT)在烧伤临床诊疗中应用较为普遍。与传统意义的PPV相比,烧伤PPT在适应证、流程细节、注意事项等方面存在显著差异。因此,中国老年医学学会烧创伤分会和中华医学会烧伤外科学分会重症学组汇总循证证据,牵头制订了《成人烧伤俯卧位治疗全国专家共识(2022版)》,从PPT作用机制、适应证、使用流程等方面形成推荐意见,以供临床参考。

     

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  • 1  手动烧伤翻身床结构示意图。1A.准备就绪后的侧面观;1B.仅铺设大孔海绵的侧面观;1C.后面观

    注:图片引自http://www.kfkf.cn/

    2  成人烧伤俯卧位通气流程。2A.于患者额头、颧骨、双肩、胸前区、髂嵴、膝部、小腿部及其他骨隆突在俯卧位时易受压处垫上棉垫/泡沫型减压敷料/硅胶软枕;2B.患者四肢并拢,上面铺大孔海绵垫;2C.海绵垫上安置翻身床片,并用绳带辅助固定;2D.保证上下床片间有一螺丝固定后,松撑脚、松活塞;2E.再次明确位置与分工,检查管道,商议好翻转方向,向清醒患者简单解释操作;2F.翻身至俯卧位;2G.重新接上呼吸机,快速拆除绳带和翻身床片;2H.逐步去除海绵垫及棉垫等,再次检查各种管道通畅性;2I.调整患者头部及四肢等位置,帮助患者取舒适卧位,摆放肢体于功能位,避免胸腹部受压,保护易受压部位

    表1  GRADE推荐强度分级与证据级别

    推荐强度 证据级别 使用推荐
    强推荐(1) 高级别证据(A) 必须使用
    中等级别证据(B) 可能应该使用
    专家建议 证据不足 本领域相关RCT非常有限
    弱推荐(2) 低等级别证据(C) 可能不应该使用
    极低级别证据(D) 不能使用
    注:GRADE为推荐意见分级的评估、制订及评价,RCT为随机对照试验
    下载: 导出CSV
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  • 收稿日期:  2021-12-08

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