胸部物理治疗集束化管理在严重腹腔感染患者中的应用

Application of chest physiotherapy bundle management in patients with severe abdominal infection

目的探讨胸部物理治疗集束化管理在严重腹腔感染患者中的应用。方法选择入住我科ICU的严重腹腔感染患者120例,按入院单双号顺序分为两组,单号为试验组60例,采取胸部物理治疗集束化管理及三步缩唇呼吸法、四步有效咳嗽法、五步叩背法、六步雾化吸入法;双号为对照组60例,采取呼吸道常规护理。观察并记录两组患者24h、48h、168h心率、血压、血氧饱和度(SpO2)、呼吸频率及自主排痰能力,以及48h、168h肺不张的发生、肺部感染及气管插管情况。结果通过胸部物理治疗集束化管理后,试验组患者168h自主排痰能力好于对照组(P<0.05);24h、48h、168h,心率、SpO2、呼吸频率明显好于对照组(P<0.05或P<0.01);168h肺不张发生、气管插管、肺部感染患者明显少于对照组(P<0.05)。结论应用胸部物理治疗集束化管理,能改善严重腹腔感染患者的氧合和自主排痰能力,减少肺不张的发生和气管插管患者、有效减少肺部感染发生。

Objective To explore the application of chest physiotherapy bundle management in patients with severe abdominal infection. Methods Totally 120 ICU patients with severe abdominal infection were divided into two groups. The patients in the experimental group received chest physiotherapy bundle management,including three-step half-closed lip breathing,four-step effective cough,five-step back-slap and six-step nebulization. The patients in the control group received routine respiratory care. The heart rate,blood pressure,oxygen saturation（SpO2）, respiratory rate and autonomous expectoration capacity at 24h,48h and 168h were recorded. Moreover,the incidences of atelectasis,pulmonary infection and trachea intubation at 48h and 168h were recorded. Results The patients＇ autonomous expectoration capacity at 168h in the experimental group was significantly better than that in the control group（P〈0.05）. The heart rate,SpO2 and respiratory rate at 24h,48h and 168h in the experimental group were significantly better than that in the control group（P〈0.05 or P〈0.01）. Moreover,the incidences of atelectasis,pulmonary infection and tracheal intubation in the experinebtal group were significantly lower than those in the control group（P〈0.05）. Conclusion The application of chest physiotherapy bundle management can improve the level of SpO2 and autonomous expectoration capacity,reduce the incidence of ateleetasis,intubation and pulmonary infection.