短期强化用力呼气训练对老年髋部骨折患者的肺部感染发生率及肺功能的影响

Effects of Short-term Intensive Forced Expiratory Training Applied to Elderly Hip Fracture Patients

目的探讨短期强化用力呼气训练应用于老年髋部骨折患者的效果。方法选取我院2017年1月至2019年12月收治的40例老年髋部骨折患者,分为对照组n=20,给予肺功能康复,可通过鼻缓慢深呼吸并屏气,经口缓慢呼气,在吸气时腹部向外凸出,呼吸时腹部向内凹陷,重复呼吸的动作约20次,每天在饭后训练2次,观察组n=20,在对照组基础上增加短期强化用力呼气训练,其中包括对患者取半卧位,腹式呼吸,通过屏气3s,之后呼出,重复多次,等到痰液集聚于咽喉处,咳出。腹式呼吸训练:将患者的双手放置于胸腹部,通过鼻腔均匀缓慢的吸气直至腹部隆起,胸部固定,嘴唇缩小,缓慢呼气,每次20组,每天训练2次。其中可观察两组肺功能指标、气流峰流速和肺部感染率。结果干预后,观察组(肺活量(VC)、第1秒用力呼吸量(FEV1)、第1秒用力呼吸量与用力肺活量的比值(FEV1/FVC)、最大通气量(MVV)较对照组高(P<0.05);观察组气流峰流速高于对照组(P<0.05);观察组伤后肺部感染率10.00%较对照组40.00%低(P<0.05)。结论对老年髋部骨折患者进行短期强化呼吸训练可提高其痰液的排痰能力,减少损伤后肺部感染的发生率,并改善其肺功能。

Objective To investigate the effects of short-term intensive forced expiratory training applied to elderly hip fracture patients.Methods The study selected 40 elderly hip fracture patients admitted to our hospital from January 2017 to December 2019 and divided them into a control group n=20.They were given pulmonary function rehabilitation.They can breathe slowly and deeply through the nose and hold their breath,and exhale slowly through the mouth.The abdomen bulges outward when inhaling,and the abdomen is sunken inward when breathing.Repeat breathing exercises about 20 times.Train 2 times a day after meals.Observation group n=20.Add short-term intensive forced exhalation training to the control group,including taking the patient in a semi-recumbent position,breathing abdominally,holding the breath for 3 seconds,then exhaling,repeating it many times,waiting until the sputum is collected in the throat and coughing up.Abdominal breathing training:Place the patient’s hands on the chest and abdomen,and inhale evenly and slowly through the nasal cavity until the abdomen bulges,the chest is fixed,the lips are reduced,and the breath is slowly exhaled.20 sets each time,training 2 times a day.Among them,two groups of pulmonary function indexes,peak airflow velocity and lung infection rate can be observed.Results After the intervention,the patients in the observation group (vital capacity (VC),forced expiratory volume in 1 s (FEV1),ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC),maximal ventilation (MVV) were higher than those in the control group (P<0.05),the peak airflow flow rate was higher than that in the observation group (P<0.05),and the rate of postinjury pulmonary infection was 10.00% lower than that in the control group (40.00% P<0.05).Conclusion Short term intensive forced expiratory training applied to elderly hip fracture patients can reduce the incidence of postinjury pulmonary infection and subsequently improve their pulmonary function.