摘要
目的探讨胸部物理治疗对机械通气患者膈肌功能的影响.方法选取某医院急诊重症监护病房2018年10月-2019年12月收治的有创机械通气患者54例,随机分为试验组29例和对照组25例.试验组在常规机械通气护理的基础上进行胸部物理治疗,对照组采取常规机械通气护理措施.两组分别于干预前、干预3d、5d后,测量患者吸气末膈肌厚度、呼气末膈肌厚度、膈肌增厚分数.在干预前及干预5d后行动脉血气分析,计算患者氧合指数.比较两组机械通气时间、ICU住院时间、脱机成功率的情况.结果干预3d、5d后,两组吸气末膈肌厚度、膈肌增厚分数比较,差异具有统计学意义(P<0.05);呼气末膈肌厚度比较,差异无统计学意义(P>0.05).干预5d后,两组氧合指数比较,差异具有统计学意义(P<0.05).试验组机械通气时间及ICU住院时间显著少于对照组(P<0.05).两组脱机成功率比较,差异无统计学意义(P>0.05).结论胸部物理治疗可改善患者的膈肌功能和氧合状态,缩短机械通气时间和ICU住院时间.
Objective To explore the effect of Chest Physiotherapy(CPT)on diaphragmatic function in patients with mechanical ventilation.Methods 54 patients who were treated with mechanical ventilation from October 2018 to December 2019 in the Emergency Intensive Care Unit(EICU)were selected,and divided into experimental group and control group randomly.The control group received routine mechanical ventilation nursing measures,and the experimental group received CPT on the basis of the measures in control group.Bedside ultrasound examination was performed to measure the diaphragmatic thickness at the end of inspiratory,the diaphragmatic thickness at the end of expiratory,and diaphragm thickening fraction(DTF)before the intervention and 3 days and 5 days after intervention in both groups.The arterial blood of the patients was collected before intervention and 5 days after the intervention,the arterial blood gas analysis was performed to obtain the oxygenation index of the patients.The mechanical ventilation time,the length of ICU stay,and rate of success weaning in the two groups of patients were compared.Results After 3 days and 5 days of intervention,the diaphragmatic thickness at the end of inspiratory and the DTF between the two groups were significantly different(P<0.05).The diaphragmatic thickness at the end of expiratory between the two groups was not different significantly(P>0.05).After 5 days of intervention,the oxygenation index of the two groups was significantly different(P<0.05).The mechanical ventilation time and length of ICU stay in the experimental group were significantly shorter than the control group(P<0.05).There was no statistically difference in the rate of success weaning between the two groups(P>0.05).Conclusion CPT can improve diaphragmatic function and oxygenation in patients with mechanical ventilation,reduce mechanical ventilation time and the length of ICU stay.
作者
杨卓
迟红丽
刘磊
张春岩
梁佳
雷雨
YANG Zhuo;CHI Hongli;LIU Lei;ZHANG Chunyan;LIANG Jia;LEI Yu(Emergency Intensive Care Unit,The First Hospital of Jilin University,Changchun,130021,China;不详)
出处
《中华急危重症护理杂志》
2020年第4期336-340,共5页
Chinese Journal of Emergency and Critical Care Nursing
基金
吉林大学第一医院护理科研基金项目(04021620001)
关键词
物理治疗技术
通气机
机械
膈
Physical Therapy Modalities
Ventilators,Mechanical
Diaphragm
作者简介
通信作者:迟红丽,E-mail:chl-icu@163..com;杨卓:女,硕士,主管护师,E-mail:574423900@qq.com
