分阶段式呼吸肌训练对提高呼吸衰竭患者无创通气撤机成功率的影响

Effects of staged respiratory muscle training on the success rate of weaning patients with respiratory failure by noninvasive ventilation

目的探究分阶段式呼吸肌训练对提高呼吸衰竭患者无创通气撤机成功率的影响。方法选取2020年1月—2022年12月在南京医科大学附属淮安第一医院呼吸与危重症医学科(pulmonary and critical care medicine,PCCM)治疗的102例呼吸衰竭患者为研究对象。采用随机数字表法将患者分为对照组和观察组,每组51例。对照组实施常规护理干预,观察组在对照组基础上实施分阶段式呼吸肌训练。分别于干预前和干预2周后比较2组患者撤机成功率、机械通气时间及呼吸肌力水平及氧合指数情况。结果干预2周后,观察组撤机成功率高于对照组,且机械通气时间短于对照组,差异均有统计学意义(P<0.05);干预后,2组最大口腔吸气压(MIP)、最大口腔呼气压(MEP)及氧合指数均高于干预前,且观察组高于同期对照组,差异有统计学意义(P<0.05)。结论分阶段式呼吸肌训练在临床护理中效果较好,可促进呼吸衰竭患者呼吸肌力恢复,改善膈肌功能,缩短机械通气时间,提高撤机成功率。

Objective To explore the effect of staged respiratory muscle training on the success rate of noninvasive ventilation weaning in patients with respiratory failure.Methods A total of 102 patients with respiratory failure treated at the department of pulmonary and critical care medicine(PCCM)in the First Huaian Hospital Affiliated to Nanjing Medical University from January 2020 to December 2022 were selected as the subjects.Patients were divided into the control group and the observation group by randomly number table method,with 51 cases in each group.The control group was given routine nursing intervention,and the observation group was given staged respiratory muscle training on the basis of the control group.Before and 2 weeks after the intervention,the success rate of weaning,the duration of mechanical ventilation,and the level of respiratory muscle strength and oxygenation index were compared between the two groups.Results After 2 weeks of intervention,the success rate of weaning in the observation group was higher than that in the control group,and the duration of mechanical ventilation was shorter than that in the control group,and the differences were statistically significant(P<0.05).After the intervention,the maximum oral suction pressure(MIP),maximum oral breath pressure(MEP),and oxygenation index of both groups were higher than those before the intervention,and those of the observation group was higher than those of the control group at the same period,and the differences were statistically significant(P<0.05).Conclusion Staged respiratory muscle training has a good effect in clinical nursing,which can promote the recovery of respiratory muscle strength,improve diaphragmatic function,shorten the time of mechanical ventilation,and increase the success rate of weaning.