早期呼吸功能训练对ICU呼吸衰竭有创机械通气老年患者步行能力及肺通气功能的影响

Effect of early respiratory function training on walking ability and lung ventilation function of elderly patients with invasive mechanical ventilation in ICU respiratory failure

目的:研究早期呼吸功能训练对重症监护病房(ICU)呼吸衰竭有创机械通气老年患者步行能力及肺通气功能的影响。方法:选取2018年4月至2019年12月于我院就诊的重症监护病房(ICU)住院超过2周的呼吸衰竭有创机械通气老年患者125例,按照随机数字表法分为对照组(62例)和研究组(63例)。对照组给予基础药物治疗和有创机械通气,研究组在对照组的基础上增加早期呼吸功能训练。观察治疗2周后两组患者肌力、步行能力、肺通气功能指标。结果:干预后研究组MRC评分高于对照组(P<0.05),步行能力优良率显著高于对照组(P<0.05),用力肺活量(FVC)、最大通气量(MVV)、卧位静息动脉血氧分压(PaO2)均显著高于对照组(P<0.05),二氧化碳分压(PaCO2)显著低于对照组(P<0.05)。结论:早期呼吸功能训练能够显著提高ICU呼吸衰竭有创机械通气老年患者的肌力,改善肺通气,提高步行能力,可临床推广。

Objective:To study the effects of early respiratory function training on the walking ability and lung ventilation function of elderly patients with invasive mechanical ventilation in respiratory failure in intensive care unit(ICU).Methods:125 elderly patients with respiratory failure and invasive mechanical ventilation who were hospitalized in the intensive care unit(ICU)of our hospital from April 2018 to December 2019 for more than 2 weeks were divided into control groups(62 Cases)and research group(63 cases).The control group was given basic drug treatment and invasive mechanical ventilation,and the research group added early respiratory function training on the basis of the control group.The indexes of muscle strength,walking ability and lung ventilation function of the two groups of patients after 2 weeks of treatment were observed.Results:After the intervention,the MRC score of the study group was higher than that of the control group(P<0.05);the excellent rate of walking ability was significantly higher than that of the control group(19.05%vs 4.84%,P<0.05);forced vital capacity(FVC)and maximum ventilation(MVV),resting arterial blood oxygen partial pressure(PaO2)is significantly higher than that of the control group(P<0.05),carbon dioxide partial pressure(PaCO2)is significantly lower than that of the control group(P<0.05).Conclusion:Early respiratory function training can significantly improve the muscle strength of elderly patients with ICU respiratory failure invasive mechanical ventilation,improve lung ventilation,improve walking ability,and can be clinically promoted.