胸部物理治疗对不同疾病不同危重程度患儿生命体征的影响

Influence of Chest Physical Therapy on Vital Signs of Critically Ill Children

目的探讨胸部物理治疗对不同疾病的危重患儿生命体征的影响。方法选择2008年1月—2009年12月356例入住PICU并行胸部物理治疗的患儿,均进行危重评分,各诊断病例按危重评分进行分组比较,观察各组在实施胸部物理治疗时的心率、呼吸、血压、氧饱和度有无异常的影响。结果危重组肺炎患儿氧饱和度和血压异常例数较非危重组患儿多,差异有统计学意义(P<0.05);极度危重组脓毒症患儿心率、呼吸、血压、氧饱和度异常较危重组患儿多,差异均有统计学意义(P<0.001);极度危重组呼吸窘迫综合征患儿心率异常数较危重组患儿多,差异有统计学意义(P<0.01);非危重组、危重组和极度危重组先天性心脏病肺炎患儿心率、呼吸、血压、氧饱和度异常例数差异均有统计学意义(P<0.001),极度危重组各指标异常例数最多;非危重组、危重组和极度危重组白血病患儿心率、呼吸、血压、氧饱和度异常例数差异均有统计学意义(P<0.001),极度危重组各指标异常例数最多。结论胸部物理治疗在危重患儿中应用,由于刺激增加耗氧量,并伴随心率、呼吸、血压的变化,也可导致短时的氧饱和度降低,因此在操作中应加强对危重患儿的观察,及时评估危重患儿的生命体征,完善评估指标和操作技术,以减少胸部物理治疗对危重患儿生命体征的影响。

Objective To explore the influence of chest physical therapy（CPT） on vital signs of critically ill children.Methods Critical scoring was carried out among 356 hospitalized children and the children were divided into three groups based on their critical scores.The comparison was made of heart rate,respiration,blood pressure,oxygen saturation during CPT in three groups.Results There were more children with abnormal vital signs in critically ill children group than in non-critically ill children group,which indicated statistical significance.Meanwhile,in extremely critically ill children group,there were more children with abnormal vital signs.Conclusion The application of CPT in critically ill children also leads to some adverse effects,therefore monitoring of patients in CPT operation should be strengthened for their vital signs.Skills should be improved so as to lower the adverse effect of CPT on patients.