球囊膨肺联合徒手胸部震颤技术对神经重症气管切开患者的临床疗效

Effect of balloon-expanded lung combined with manual chest vibration technique in tracheotomy patients with severe neurological problems

目的:探讨球囊膨肺联合徒手胸部震颤技术对神经重症气管切开患者的临床应用疗效。方法:将符合研究的57例神经重症气管切开患者随机分为对照组28例和观察组29例。对照组采用常规气道护理及排痰技术,观察组在对照组基础上采用球囊膨肺联合徒手胸部震颤技术进行治疗。治疗观察时间2周,对比两组患者单次排痰量、第1周及第2周排痰总量、治疗2周后氧合指数及临床肺部感染评分情况。结果:治疗2周后,观察组单次排痰量较对照组明显增多(P<0.05);每周排痰总量进行比较:2组患者在第1周排痰总量比较差异无统计学意义,但第2周排痰总量较第1周均有不同程度减少(均P<0.05),且观察组较对照组减少更明显(P<0.05)。治疗2周末,2组患者氧合指数较治疗前均有明显提高(均P<0.05),且观察组较对照组提高更明显(P<0.05);2组临床肺部感染评分较治疗前均有明显下降(均P<0.05),且观察组更低于对照组(P<0.05)。结论:球囊膨肺联合徒手胸部震颤技术应用于神经重症气管切开患者能有效地提高痰液清除效果,改善肺部相关功能,值得临床推广。

Objective:To evaluate the effect of balloon expanded lung combined with manual chest vibration technique on tracheotomy patients with severe neurological problems.Method:Fifty-seven tracheotomy patients with severe neurological problems were randomly divided into observation group and control group(28 in control group,and 29 in observation group).Patients in control group were treated by conventional airway care technology.The observation group was treated by balloon expanded lung combined with manual chest vibration technique in addition to conventional airway care.All patients were treated for 2 weeks.After treatment,the amount of single sputum production and the total amount of sputum production every week were compared between groups.Changes in pulmonary oxygenation index and clinical pulmonary infection score(CPIS)were also compared after 2 weeks of treatment between two groups.Results:The amount of single sputum production in the observation group was significantly greater than that in the control group(P<0.05).At the end of the first week,there was no statistically significant difference in the amount of sputum production between the two groups(P>0.05).However,after treatment for 2 weeks,the total amount of sputum production had statistically significant difference from that at the end of the first week treatment in both two groups(P<0.05),and significantly increased in observation group as compared with that in control group(P<0.05).After treatment for 2 weeks,the scores of oxygenation index and CPSI had statistically significant difference from those before treatment in both two groups(all P<0.05),and significantly increased in observation group as compared with those in control group(P<0.05).No adverse reactions occurred in the two groups during the treatment period.Conclusion:Balloon expanded lung combined with manual chest vibration technique can effectively improve the sputum removal on tracheotomy patients with severe neurological problems and increase the lung relation functions,which is worth to clinically promote.