主动呼吸循环技术对机械通气拔管患者自主咳痰能力恢复的效果评价

摘要

目的：探讨主动呼吸循环技术对拔管患者恢复自主咳痰能力的效果。方法将75例拔管后咳痰无力或无效咳痰患者随机分为两组，对照组35例进行常规治疗，试验组40例在常规治疗基础上进行主动呼吸循环技术功能锻炼，观察两组患者自主咳痰能力、首次排痰时间、排痰量及痰鸣音情况、氧分压(PaO2)、二氧化碳分压(PaCO2)、再次插管率及初次拔管后住院天数等。结果与对照组患者比较，试验组患者在很短时间内恢复自主咳痰能力，首次排痰量明显多于对照组，患者呼吸音改善，肺部感染好转，两组间比较差异有统计学意义(P<0.05)；对照组患者再次插管率明显高于试验组患者，初次拔管后住院天数明显多于试验组患者，差异有统计学意义(P<0.05)。结论主动呼吸循环技术有助于初次拔管患者恢复自主咳痰能力，保持呼吸道通畅，避免CO2潴留，防止分泌物坠积所致肺不张和肺炎，有效降低再次插管率，促进肺功能的恢复。%Objective To evaluate the effectiveness of active cycle of breathing techniques on the ability of independent expectoration in patients after extubation.Methods 75 patients with incapable or invalid expectoration after extubation were randomly divided into control group(n=35)and experimental group (n=40).The patients in experimental group were cared by active cycle of breathing techniques,while patients in control group were cared by conventional nursing during ex-tubation.The ability of independent expectoration,the first moment of expectoration,the amount of expectoration,coarse rales ,levels of PaO2 and PaCO2 were evaluated after extubation.The reintubation rate and hospitalization days after the first extubation were analyzed.Results Compared to the control group,patients in the experimental group recovered in less time and the amount of expectoration for the first time was more,breathing and pulmonary infection were improved,there was significant difference between the two groups(P<0. 05).The reintubation rate and hospitalization days after the first extubation in the control group were significantly higher than that in the experimental group (P<0.05).Conclusions Active cycle of breathing technique was useful in the recovery of independent expectoration in patients after the first extubation,it can maintain airway patency and prevent carbon dioxide retention or pulmonary infection,it was also an effective way on avoiding reintubation and promoting the recovery of pulmo-nary function.