徒手膨肺联合胸廓震动挤压在重症康复病房气管切开患者中的应用

摘要

Objective:To explore the therapeutic effects of manual hyperinflation combined with thorax vibration on tracheotomy patient admitted to intensive rehabilitation care unit (IRCU).Method:Totally 78 tracheotomy patients in IRCU were divided into control group receiving routine sputum excretion treatment and trial group receiving manual hyperinflation combined with thorax vibration treatment.All patients were treated 28 days.Once mount of expectoration and daily average amount of expectoration were measured.Clinical pulmonary infection score(CPIS) of two groups were also recorded.Result:Manual hyperinflation combined with thorax vibration significantly increased once amount of expectoration compared with sputum excretion(P＜0.05).Daily average amount of expectoration showed no difference between two groups at first week.Daily average amount of expectoration of trial group was significantly less than that of control at second,third and forth week(P＜0.05).The CPIS of trial group was significantly less than that of control group(P＜0.05)at the first,second,third and forth week.Conclusion:Manual hyperinflation combined with thorax vibration can promote sputum excretion and decrease pneumonia incidence.%目的:探讨徒手膨肺联合胸廓震动挤压在重症病房气管切开患者中的应用效果.方法:76例重症康复病房收治的气管切开患者随机分为对照组及干预组,对照组采用常规排痰技术,干预组采用徒手膨肺联合胸廓震动挤压排痰技术.观察时间为28天,对比两组患者单次排痰量及每周日均排痰总量和临床肺部感染评分(CPIS).结果:徒手膨肺联合胸廓震动挤压排痰量较震动排痰仪单次排痰量多,差异有显著性意义(P＜ 0.05);第1周统计的两组患者日均排痰总量差异无显著性意义,但第2周、第3周、第4周,干预组日均排痰总量均较对照组少,差异有显著性意义(P＜0.05);两组患者入科时CPIS评分差异无显著性意义,但在第1、2周及第3、4周最低CPIS评分干预组均较对照组低,差异具有显著性意义(P＜ 0.05).结论:徒手膨肺联合胸廓震动挤压应用于重症病房气管切开患者能提高痰液清除效果及降低肺部感染发生.