人工膨肺技术在颈髓损伤气管切开患者肺康复中的应用

doi:10.3761/j.issn.0254-1769.2021.01.011

摘要/Abstract

摘要：

目的探讨人工膨肺技术在颈髓损伤气管切开患者肺康复中的应用效果。方法将2017年1月—2019年9月收治的66例颈髓损伤并行气管切开的患者按SPSS系统产生区组随机数字表分为试验组和对照组,每组33例,试验组在雾化吸入、震动排痰、腹部挤压后吸痰等常规肺康复护理的基础上增加人工膨肺技术,对照组采用常规肺康复护理。比较实施肺康复前和实施肺康复4周后两组的肺活量、第1秒用力呼气容积、最大呼气量以及干预期间两组的肺不张发生率。结果干预4周后,试验组的肺活量、第1秒用力呼气容量、最大呼气量分别是（4.17±0.70） L、（3.86±0.94） L、（266.67±36.70） L均高于对照组的（3.06±0.73） L、（2.91±0.72） L、（221.73±19.53） L,差异有统计学意义（P<0.05）;试验组、对照组的肺不张发生率分别为3.03%、24.24%,两组比较,差异有统计学意义（P<0.05）。结论人工膨肺技术应用于颈髓损伤气管切开患者中能够有效提高患者的肺功能,增加患者肺部的顺应性,减少患者肺不张、肺塌陷的发生,明显改善患者肺康复的效果。

关键词: 人工膨肺, 腹部挤压, 颈髓损伤, 气管切开, 肺康复, 护理

Abstract:

Objective To explore the effects of pulmonary rehabilitation technique combined with manual hyperinflation on patients with cervical spinal cord injury after tracheotomy. Methods From January 2017 to September 2019,66 patients with cervical spinal cord injury after tracheotomy were enrolled in this study. They were randomly allocated to an experimental group with 33 cases and a control group with 33 cases according to the block random number table generated by SPSS. In the experimental group,manual hyperinflation technique was added on the basis of routine lung rehabilitation nursing care,such as aerosol inhalation,vibration sputum expectoration,and sputum suction after abdominal compression. In the control group,routine lung rehabilitation nursing care was adopted. Before and after the intervention for 4 weeks,vital capacity（FVC）,forced expiratory volume in a second（FEV1）,maximum expiratory volume（PEF） were examined using spirometer and the incidence of atelectasis was calculated in both groups. Results After 4 weeks of interventions,FVC（4.17±0.70） L,FEV₁（3.86±0.94） L,PEF（266.67±36.70） L in the experimental group were significantly higher than these in the control group with FVC（3.06±0.73） L,FEV₁（2.91±0.72） L,PEF（221.73±19.53） L（P<0.05）,and the incidence of pulmonary atelectasis in the experimental group（3.03%）was lower than that in the control group（24.24%）（P<0.05）. Conclusion In patients with cervical spinal cord injury after tracheotomy,the application of manual hyperinflation technique can effectively improve the pulmonary function,increase the lung compliance of patients,reduce the occurrence of atelectasis and pulmonary collapse,and significantly improve the effects of pulmonary rehabilitation.

Key words: Pulmonary Rehabilitation, Nursing Care, Manual Hyperinflation, Abdominal Extrusion, Cervical Spinal Cord Injury, Tracheotomy, Pulmonary Rehabilitation, Nursing Care

邓水娟,周春兰,周君桂,刘瑜,周洲,钱大棣. 人工膨肺技术在颈髓损伤气管切开患者肺康复中的应用[J]. 中华护理杂志, 2021, 56(1): 69-72.

DENG Shuijuan,ZHOU Chunlan,ZHOU Jungui,LIU Yu,ZHOU Zhou,QIAN Dadi. Application of pulmonary rehabilitation technique combined with manual hyperinflation in patients with cervical spinal cord injury after tracheotomy[J]. Chinese Journal of Nursing, 2021, 56(1): 69-72.

图/表 2

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