气道廓清技术联合囊上吸痰对脑卒中气管切开患者呼吸道管理的疗效观察

Effect of airway clearance combined with supracapsular sputum aspiration on respiratory tract management in stroke patients with tracheotomy

目的:探讨气道廓清技术联合囊上吸痰在脑卒中气管切开患者呼吸道管理中的临床应用效果。方法:选取2020年2月至2021年2月大连医科大学附属第二医院收治的80例脑卒中气管切开患者为研究对象,随机分为对照组和研究组,各40例。对照组采用常规治疗,研究组在对照组基础上实施气道廓清技术和囊上吸痰技术,比较干预前后2组患者的排痰情况、痰液性质、血气分析、呼吸困难程度(mMRC评分)和日常生活自理能力(MBI评分)。结果:研究组患者干预后的排痰情况评分、痰液性质评分、mMRC评分低于对照组(P<0.05);研究组患者干预后的MBI量表评分高于对照组(P<0.05);研究组患者干预后的PaO_(2)、PaCO_(2)、pH水平优于对照组(P<0.05)。组内比较:研究组干预后排痰情况、痰液黏稠度和颜色较干预前明显好转(P<0.05);研究组干预后较干预前PaO_(2)明显升高、PaCO_(2)明显下降(P<0.05),pH值有升高趋势,但差异无统计学意义(P>0.05);研究组干预后mMRC评分较干预前明显下降、MBI评分明显升高(P<0.05)。结论:气道廓清技术联合囊上吸痰治疗可有效改善脑卒中气管切开患者的排痰情况和痰液性质,提高患者的呼吸功能和日常生活自理能力。

Objective:To investigate the clinical effect of airway clearance combined with supracapsular sputum aspiration on respiratory tract management in stroke patients with tracheotomy.Methods:A total of 80 cases of stroke patients with tracheotomy in the Second Affiliated Hospital of Dalian Medical University from Feb 2020 to Feb 2021 were selected as the research subjects and randomly divided into the control group and the intervention group,with 40 cases in each group.The control group was treated with conventional treatment,and the intervention group was treated with airway clearance technology and sputum aspiration technology on the basis of the control group.The sputum discharge,sputum properties,blood gas analysis,degree of dyspnea(m MRC score)and self-care ability in daily life(MBI score)were compared between the two groups before and after the intervention.Results:After intervention,the scores of sputum excretion,sputum properties and mMRC in the intervention group were lower than those in the control group(P<0.05).And the MBI score in the intervention group was higher than that in the control group(P<0.05).The levels of PaO_(2),PaCO_(2)and pH in the intervention group were better than those in the control group(P<0.05).After intervention,sputum condition,sputum viscosity and color in the intervention group were significantly improved compared with those before intervention(P<0.05).And PaO_(2)was significantly increased and PaCO_(2)was significantly decreased in the intervention group compared with those before intervention(P<0.05),but the difference of p H was not statistically significant(P>0.05).The mMRC score significantly decreased and MBI score significantly increased after intervention compared with those before intervention in the intervention group(P<0.05).Conclusion:Airway clearance combined with supracapsular sputum aspiration can effectively improve sputum excretion and sputum properties in stroke patients with tracheotomy,and improve respiratory function and self-care ability in daily life.