目的 探讨俯卧位通气对重症肺炎患者发生谵妄的影响。方法 回顾性分析2022年12月至2023年1月上海市某三级甲等医院监护室收治的106名重症肺炎伴低氧血症患者，分为俯卧位通气（prone position ventilation，PPV）组（n=54）和对照组（采用常规仰卧位，n=52），统计两组患者干预前后基础情况、生命体征、实验室检查及并发症情况。结果 行俯卧位通气3 d与7 d后，PPV组的谵妄发生率以及c反应蛋白、白细胞介素-6、白细胞介质-8以及肿瘤坏死因子-α等水平均低于对照组（均P＜0.05）；PPV组氧合指数呈上升趋势，炎症因子总体呈下降趋势，且两组比较差异均有统计学意义（均P＜0.05）。结论 俯卧位通气可能通过抑制炎症和改善氧合情况，来降低重症肺炎患者的谵妄发病率。

Objective To explore the effects of prone position ventilation on delirium in patients with severe pneumonia and hypoxaemia.Methods Retrospective analysis was used to analyze 106 patients with severe pneumonia,who were admitted to the intensive care unit of a tertiary hospital in Shanghai from December 2022 to January 2023.They were divided into a prone position ventilation (PPV) group (n=54) and a control group (in the supine position,n=52).The patients’ basic condition,vital signs,laboratory tests,and complications were analyzed.Results After 3 and 7 days of prone position ventilation,the incidence of delirium,the level of CRP,IL-6,IL-8 and TNF-α in the PPV group were lower than those of the control group (all P＜0.05).P/F in PPV group showed an increasing trend and the difference between the two groups was statistically significant (all P＜0.05).The overall inflammatory factors in PPV group showed a decreasing trend and the difference between the two groups was statistically significant (all P＜0.05).Conclusions Prone position ventilation may reduce the incidence of delirium in patients with severe pneumonia by inhibiting inflammation and improving oxygenation.

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上海交通大学医学院护理学科建设项目（SJTUHLXK2022）