阶梯式氧疗联合体位管理对急性高原肺水肿 患者血氧饱和度及肺顺应性的影响

The Effect of Stepwise Oxygen Therapy Combined with Position Management on Blood Oxygen Saturation and Pulmonary Compliance in Patients with Acute High Altitude Pulmonary Edema

摘要: 目的：探讨阶梯式氧疗联合体位管理对急性高原肺水肿患者血氧饱和度及肺顺应性的影响。方法：选取42例2025年11月~2026年3月在本院高原医学科治疗的急性高原肺水肿患者，随机分作两组，21例氧疗组行阶梯式氧疗，21例联合组予以阶梯式氧疗联合体位管理，对比两组血氧饱和度与肺顺应性、氧合状态、氧疗并发症。结果：联合组干预后血氧饱和度是(95.76 ± 6.43)%，动态肺顺应性是(31.02 ± 2.18) mL/cmH₂O，分别较氧疗组的(90.87 ± 6.56)%、(28.83 ± 2.24) mL/cmH₂O高(P < 0.05)；联合组干预后氧合指数较氧疗组高，呼吸频率较氧疗组低(P < 0.05)；联合组氧疗并发症(4.76%)少于氧疗组(28.57%)。结论：予以急性高原肺水肿患者阶梯式氧疗联合体位管理可促进其血氧饱和度、肺顺应性有效提升，使其氧合状态进一步改善，并提升氧疗安全性。

Abstract: Objective: To explore the effect of stepwise oxygen therapy combined with position management on blood oxygen saturation and pulmonary compliance in patients with acute high altitude pulmonary edema. Method: 42 patients with acute high altitude pulmonary edema treated in the High Altitude Medicine Department of our hospital from November 2025 to March 2026 were randomly divided into two groups. The 21 patients in the oxygen therapy group received stepwise oxygen therapy, while the 21 patients in the combination group received stepwise oxygen therapy combined with position management. The blood oxygen saturation, lung compliance, oxygenation status, and oxygen therapy complications were compared between the two groups. Results: After intervention, the blood oxygen saturation in the combined group was (95.76 ± 6.43)%, and the dynamic pulmonary compliance was (31.02 ± 2.18) mL/cmH₂O, which were higher than those in the oxygen therapy group [(90.87 ± 6.56)%, (28.83 ± 2.24) mL/cmH₂O, respectively] (P < 0.05); the oxygenation index in the combined group was higher, and the respiratory rate was lower than that in the oxygen therapy group (P < 0.05); the oxygen therapy complications in the combined group (4.76%) were less than those in the oxygen therapy group (28.57%). Conclusion: Stepwise oxygen therapy combined with position management for patients with acute high altitude pulmonary edema can effectively improve their blood oxygen saturation and pulmonary compliance, further improve their oxygenation status, and enhance the safety of oxygen therapy.