基于气道分级管理策略的胸部物理干预对老年重症肺炎患者康复情况的影响

Effect of Chest Physical Intervention Based on Airway Grading Management Strategy on Rehabilitation of Elderly Patients with Severe Pneumonia

目的探讨基于气道分级管理策略的胸部物理干预在老年重症肺炎患者中的应用效果.方法选取2019年4月—2021年4月该院收治的86例老年重症肺炎患者为研究对象,按随机数字表法将其分为对照组和观察组,每组43例.对照组采用常规干预,观察组采用基于气道分级管理的胸部物理干预,两组均持续干预至患者出院.比较两组的康复情况、肺功能和生活质量.结果观察组的机械通气时间、重症加强护理病房(ICU)治疗时间及住院时间分别为(6.45±1.13)d、(10.27±2.18)d、(22.49±4.12)d,均短于对照组的(9.36±1.21)d、(15.14±2.34)d、(30.20±4.38)d,差异有统计学意义(P<0.05).观察组干预后的第1秒用力呼气容积(FEV1)为(1.50±0.17)L、用力肺活量(FVC)为(2.04±0.31)L、第1秒用力呼气容积/用力肺活量(FEV1/FVC)为(63.18±5.39)%、呼气峰流速(PEF)为(346.89±22.67)L/min、最大通气量(MVV)为(89.60±10.38)L,均高于对照组的(1.35±0.15)L、(1.75±0.26)L、(59.89±5.36)%、(328.98±22.56)L/min、(85.87±10.24)L,差异有统计学意义(P<0.05).观察组干预后的圣乔治呼吸问卷(SGRQ)中疾病影响、活动受限及呼吸症状评分分别为(40.35±3.27)分、(40.37±3.38)分、(40.12±3.44)分,均低于对照组的(47.85±3.32)分、(45.69±3.42)分、(44.71±3.46)分,差异有统计学意义(P<0.05).结论将基于气道分级管理策略的胸部物理干预应用于老年重症肺炎患者中,能够改善其肺功能,提高生活质量,加快患者康复进程.

Objective To explore the effect of chest physical intervention based on airway grading management strategy in elderly patients with severe pneumonia.Methods A total of 86 elderly patients with severe pneumonia admitted to thehospital from April 2019 to April 2021 were selected as the research objects,and they were divided into a control group and an observation group according to random number table method,with 43 cases in each group.Conventional intervention was used in the control group,and chest physical intervention based on airway grading management was used in the observation group.Intervention was continued until discharge in both groups.The rehabilitation,lung function and quality of life of the two groups were compared.Results The duration of mechanical ventilation,intensive care unit(ICU)treatment and hospital stay of the observation group were(6.45±1.13)d,(10.27±2.18)d,(22.49±4.12)d,respectively,which were shorter than(9.36±1.21)d,(15.14±2.34)d,(30.20±4.38)d of the control group,and the differences were statistically significant(P<0.05).The forced expiratory volume in one second(FEV1),forced vital capacity(FVC),The forced expiratory volume in one second/forced vital capacity(FEV1/FVC),peak expiratory flow rate(PEF)and maximal voluntary ventilation(MVV)of the observation group were(1.50±0.17)L,(2.04±0.31)L,(63.18±5.39)%,(346.89±22.67)L/min and(89.60±10.38)L,respectively,which were higher than(1.35±0.15)L,(1.75±0.26)L,(59.89±5.36)%,(328.98±22.56)L/min,(85.87±10.24)L of the control group,the differences were statistically significant(P<0.05).The scores of disease influence,activity restriction and respiratory symptoms in the St.George respiratory questionnaire(SGRQ)of the observation group were(40.35±3.27)points,(40.37±3.38)points,(40.12±3.44)points,respectively,which were lower than(47.85±3.32)points,(45.69±3.42)points,(44.71±3.46)points of the control group,the differences were statistically significant(P<0.05).Conclusion Chest physical intervention based on airway grading management strategy can improve the lung function and the quality of life,speed up the rehabilitation process of elderly patients with severe pneumonia.