| 李 响,张洪蕊,刘陵鑫,杨 帅,霍飞翔,吴 迪,孙亚鲁.个性化气道廓清技术对重症康复病房气管切开患者拔管的影响[J].中国康复医学杂志,2024,(5):641~646 |
| 个性化气道廓清技术对重症康复病房气管切开患者拔管的影响 点此下载全文 |
| 李 响 张洪蕊 刘陵鑫 杨 帅 霍飞翔 吴 迪 孙亚鲁 |
| 济宁医学院附属医院，山东省济宁市，272000 |
| 基金项目： |
| DOI：10.3969/j.issn.1001-1242.2024.05.005 |
| 摘要点击次数: 861 |
| 全文下载次数: 559 |
| 摘要： |
| 摘要
目的：观察个性化气道廓清技术对重症康复病房气管切开患者拔管的影响。
方法：将符合纳入标准的62例重症康复病房气管切开患者分为对照组和试验组，每组31例，在观察期间对照组和试验组各有1例患者脱落。对照组在常规康复的基础上给予体位引流结合叩背，试验组在常规康复的基础上给予个性化气道廓清技术（包括咳嗽训练﹑主动呼吸循环技术﹑体位引流等）。观察周期为6周，对比两组患者的排痰量﹑拔管时间﹑拔管成功率以及临床肺部感染情况。
结果：训练6周结束后，试验组在训练期间的平均排痰量明显多于对照组，差异具有显著性意义（P<0.05）；在训练第1周时，两组患者在日均排痰量组间差异无显著性意义（P>0.05），在第2、4、6周时，试验组的日均排痰量均较对照组明显减少，差异具有显著性意义（P<0.05）；训练前，两组患者的临床肺部感染评分（cinical pulmonary infection score，CPIS）组间差异无显著性意义（P>0.05），但在第1、3、6周后，试验组的CPIS评分均较对照组明显降低，差异具有显著性意义（P<0.05）；重复测量方差分析结果显示，两组患者的日均排痰量和CPIS评分的时间效应、组间效应及交互效应均具有显著性意义（P<0.05）；试验组的拔管时间比对照组明显缩短（P<0.05）；且试验组的拔管成功率为93.3%，明显高于对照组的70.0%，差异具有显著性意义（P<0.05）。
结论：个性化气道廓清技术能更有效地改善重症康复病房气管切开患者肺部感染情况，缩短气管套管的拔除时间，提高拔管的成功率。 |
| 关键词：气道廓清技术 气管切开 重症康复病房 拔管 |
| Effects of personalized airway clearance therapy on extubation in patients with tracheotomy in intensive rehabilitation care unit Download Fulltext |
|
| Department of Rehabilitation Medicine， Affiliated Hospital of Jining Medical University， Jining， Shandong， 272000 |
| Fund Project: |
| Abstract: |
| Abstract
Objective：To observe the effect of personalized airway clearance therapy on extubation of patients with tracheotomy in intensive rehabilitation care unit.
Method：Totally 62 patients who met the inclusion criteria were divided into the control group and experimental group， with 31 patients in each group. During the experimental period， one patient in the control group and experimental group dropped off. The control group was given the posture drainage combined with back tapping on the basis of routine rehabilitation， while the experimental group was given the personalized airway clearance therapy（including cough training， active cycles of breathing techriques， posture drainage， etc.） on the basis of routine rehabilitation. The observation period was 6 weeks， and the sputum volume， extubation time， extubation success rate and clinical pulmonary infection score were compared between the two groups.
Result：After 6 weeks of training， the average sputum volume in the experimental group was significantly higher than that in the control group（P<0.05）. At the first week of training， there was no significant difference in the average daily sputum volume between the two groups （P>0.05）， but at the second， fourth and sixth weeks， the average daily sputum volume in the experimental group was significantly lower than that in the control group（P<0.05）. Before training， there was no statistically significant difference in CPIS scores between the two groups （P>0.05）， but at the first， third and sixth weeks， CPIS scores in the experimental group were significantly lower than that in the control group（P<0.05）. The results of repeated measure ANOVA showed that the time effect， inter-group effect and interaction effect of daily expectoration volume and CPIS score in the two groups were statistically significant （P<0.05）. The extubation time in the experimental group was significantly shorter than that in the control group （P<0.05）， and the success rate of extubation in the experimental group was 93.3%， which was significantly higher than 70.0% in the control group （P<0.05）.
Conclusion：Personalized airway clearance technology can improve the pulmonary infection of patients with tracheotomy in ICU more effectively， shorten the time of tracheal tube removal， and improve the success rate of extubation. |
| Keywords:airway clearance technology tracheotomy intensive rehabilitation care unit tube drawing |
|
| 查看全文 查看/发表评论 |
