摘要
目的探讨早期分阶段肺康复锻炼治疗重症急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的疗效。方法选取2018-01至2019-12武汉市第一医院重症ARDS患者60例,采用随机数字表法分为对照组和观察组,每组30例。对照组实施常规治疗,观察组常规治疗基础上采用早期分阶段肺康复锻炼治疗,比较两组治疗前后肺通气功能指标、动脉血气状况指标和生存质量评分变化,记录两组机械通气时间、ICU治疗时间、住院时间、呼吸机相关性肺炎发生率。结果两组治疗后,1 s用力呼吸容积、1 s用力呼吸容积/肺活量比率和生存质量评分均较治疗前明显改善,PaO^(2)、SpO^(2)和氧合指数均较治疗前升高,差异有统计学意义(P<0.05)。且观察组PaCO^(2)低于对照组[(44.18±5.06)mmHg vs.(49.47±5.24)mmHg],呼吸机通气时间[(2.74±0.90)d vs.(3.98±1.22)d]、ICU治疗时间[(3.19±1.03)d vs.(4.27±1.15)d]和住院时间[(10.98±2.13)d vs.(13.76±2.69)d]均短于对照组,差异有统计学意义(P<0.05)。观察组呼吸机相关性肺炎发生率低于对照组(3.33%vs 20.00%),差异有统计学意义(P<0.05)。结论在常规治疗基础上加用早期分阶段肺康复锻炼对治疗重症ARDS安全有效。
Objective To observe the efficacy of early staged lung rehabilitation exercise in patients with severe acute respiratory distress syndrome(ARDS).Methods A total of 60 patients with severe ARDS treated in our hospital between January 2018 and December 2019 were selected.They were randomly divided into the control group and test group,with 30 cases in each.The control group received conventional treatment while the test group was additionally subjected to early staged lung rehabilitation exercise.The changes of pulmonary ventilation function,arterial blood gas indexes and scores of quality of life were observed before and after treatment and compared between the two groups after treatment.The duration of mechanical ventilation,ICU stay,hospital stay and the incidence of ventilator-associated pneumonia were recorded.Results After treatment,the forced expiratory volume in 1 second(FEV_(1)),the FEV_(1)/forced vital capacity ratio and scores of quality of life were all improved,while PaO^(2),SpO^(2)and oxygenation indexes were increased in both groups(P<0.05),especially in the test group(P<0.05).Levels of PaO^(2)[(44.18±5.06)vs(49.47±5.24)]were lower in the test group than in the control group(P<0.05).The duration of mechanical ventilation[(2.74±0.90)vs(3.98±1.22)],ICU stay[(3.19±1.03)vs(4.27±1.15)]and hospital stay[(10.98±2.13)vs(13.76±2.69)]were shorter(P<0.05)and the incidence of ventilator-associated pneumonia was lower in the test group(3.33%vs 20.00%)(P<0.05).Conclusions The combination of conventional treatment,with early staged lung rehabilitation exercise can more effectively improve the pulmonary ventilation function,reduce the risk of ventilator-associated pneumonia and improve the quality of life among patients with severe ARDS.
作者
欧阳方
何娟
马艳
OU Yangfang;HE Juan;MA Yan(Medical Center of Rehabilitation,Wuhan Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430000,China;Department of Rehabilitation Medicine,Hubei Provincial Corps Hospital of Armed Police,Wuhan 430000,China)
出处
《武警医学》
CAS
2021年第11期937-941,共5页
Medical Journal of the Chinese People's Armed Police Force
关键词
早期分阶段
急性呼吸窘迫综合征
肺康复锻炼
氧合指数
呼吸机相关性肺炎
early staged
acute respiratory distress syndrome
lung rehabilitation exercise
oxygenation index
ventilator-associated pneumonia
作者简介
欧阳方,硕士,主治医师;通讯作者:马艳,E-mail:ajuan311@qq.com
