摘要
目的分析肺康复在急性重症脑损伤机械通气患者中的临床干预效果。方法选取我院2019年1月—2020年12月收治的42例急性重症脑损伤机械通气患者为研究对象,按照入院时间分为两组。2019年1—12月入院的20例为对照组,采用常规治疗;2020年1—12月入院的22例为研究组,采用常规治疗联合肺康复。比较两组治疗前、治疗7 d后的膈肌移动度,测定治疗7 d后的肺功能,并记录机械通气时间、ICU住院时间、呼吸机相关性肺炎发生情况。结果研究组的呼吸机相关性肺炎发生率为4.55%,低于对照组的35.00%,机械通气时间及ICU住院时间均短于对照组,组间差异有统计学意义(P<0.05)。治疗前,两组的膈肌移动比较,差异无统计学意义(P>0.05);治疗7 d后,研究组的膈肌移动度高于对照组,差异有统计学意义(P<0.05)。治疗7 d后,研究组的第1秒用力呼气容积、1秒率水平均高于对照组,组间差异有统计学意义(P<0.05)。结论急性重症脑损伤机械通气患者在常规治疗的同时辅以肺康复,可提高膈肌移动度,改善肺功能,降低呼吸机相关性肺炎发生率,促进康复,进而缩短机械通气时间及ICU住院时间。
Objective To analyze the effect of pulmonary rehabilitation in mechanical ventilation patients with acute severe brain injury.Methods A total of 42 patients with mechanical ventilation after acute severe brain injury admitted to our hospital from January 2019 to December 2020 were selected as the research objects.They were divided into two groups according to the time of admission.20 patients hospitalized from January to December in 2019 were enrolled as control group and received conventional treatment,22 patients hospitalized from January to December 2020 were enrolled as the study group and received conventional treatment combined with pulmonary rehabilitation.The diaphragmatic mobility before and after 7 days of treatment was compared between the two groups,and lung function after 7 days of treatment was measured,mechanical ventilation duration,length of ICU stay and occurrence of ventilator-associated pneumonia were recorded.Results The incidence of ventilator-associated pneumonia in the study group was 4.55%,lower than 35.00%in the control group,and the mechanical ventilation time and ICU stay time were shorter than those in the control group,the differences between the groups were statistically significant(P<0.05).Before treatment,there was no significant difference in diaphragm movement between the two groups(P>0.05);after 7 days of treatment,the diaphragm movement in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).After 7 days of treatment,the first second forced expiratory volume and the rate of one second in the study group were higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).Conclusion In patients with acute severe brain injury,mechanical ventilation combined with pulmonary rehabilitation can improve diaphragm mobility,improve lung function,reduce the incidence of ventilator-associated pneumonia,promote rehabilitation,and shorten the duration of mechanical ventilation and ICU stay.
作者
赵晶
段冉
孙鹤
吴世龙
丁伟英
ZHAO Jing;DUAN Ran;SUN He;WU Shilong;DING Weiying(Department of Critical Care Medicine,Beijing Shijingshan Hospital,Beijing,100043,China)
出处
《反射疗法与康复医学》
2022年第3期56-58,74,共4页
Reflexology And Rehabilitation Medicine
关键词
肺康复
急性重症脑损伤
机械通气
肺功能
Pulmonary rehabilitation
Acute severe brain injury
Mechanical ventilation
Pulmonary function
作者简介
赵晶(1984-),女,河北张家口人,本科,住院医师,研究方向:肺部疾病诊疗。
