主动呼吸循环技术对脑卒中后气管切开患者卒中相关性肺炎的疗效研究

Effect of active cycle of breathing technique on stroke associated pneumonia after stroke tracheotomy

目的探讨主动呼吸循环技术对脑卒中后气管切开患者卒中相关性肺炎的临床干预效果。方法选择2015年6月~2017年12月我科收治的146例脑卒中后合并卒中相关性肺炎的气管切开患者随机分为观察组和对照组,各73例。对照组给予传统叩拍震动治疗,观察组给予主动呼吸循环技术治疗。评定治疗前后患者肺功能、呼吸肌肌力、卒中相关性肺炎、误吸与气管套管拔除、健康调查表(SF-36)情况。结果治疗4周后,观察组的FEV1、FVC、MIP、MEP值较治疗前明显改善(P<0.01),且观察组较对照组明显提高(P<0.05);对照组的FEV1、FVC、MIP、MEP值较治疗前有提高,但前后比较差异无明显统计学意义(P>0.05);观察组卒中相关性肺炎的改善情况明显优于对照组(P<0.01);观察组误吸发生率明显低于对照组(P<0.05),拔除气管套管例数明显高于对照组(P<0.05);观察组健康调查(SF-36)各项指标明显高于对照组(P<0.05)。结论主动呼吸循环技术可有效增强脑卒中气管切开术后患者肺功能和呼吸肌肌力,减少肺部感染情况,促进气管套管的拔除,降低误吸发生率,且优于传统叩拍震动技术。

Objective To explorethe clinical intervention effect of active cycle of breathing technique on patients with pneumonia after stroke tracheotomy.Methods 146 patients with strokeassociated pneumonia admitted in our department from June 2015 to December 2017 were randomly divided into observation group and control group with 73 cases in each group.The control group was treated with traditional slap vibration,and the observation group was treated with active cycle of breathing technique.The pulmonary function,respiratory muscle strength,strokeassociated pneumonia,aspiration and tracheal cannula removal and health survey form(SF-36)before and after treatment were assessed.Results After 4 weeks of treatment,the FEV1,FVC,MIP,and MEP values in the observation group were significantly improved compared with those before treatment(P<0.01),and the above indexes in the observation group were significantly higher than those in the control group(P<0.05);The FEV1,FVC,MIP,and MEP values in the control group were higher than those before the treatment,but the difference was not statistically significant before and after treatment(P>0.05);The improvement of stroke associated pneumonia in the observation group was significantly better than that in the control group(P<0.01);The incidence of aspiration in the observation group was significantly lower than that in the control group(P<0.05),and the number of tracheal cannula removal in the observation group was significantly higher than that in the control group(P<0.05);The indicators of health survey form(SF-36)in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Active cycle of breathing technique can effectively enhance lung function and respiratory muscle strength,reduce pulmonary infection,promote the extraction of tracheal cannula,reduce the incidence of aspiration in patients with stroke tracheotomy,and is superior to traditional slap vibration technique.