高频振动排痰对重症肺炎机械通气患儿呼吸道清理应用效果观察  

Observation on the application effect of high-frequency vibration expectoration on airway clearance in mechanically ventilated children with severe pneumonia

作　　者：廉爱芳 王凯红 田艳荣 LIAN Ai-fang;WANG Kai-hong;TIAN Yan-rong(Jiaozuo Maternal and Child Health Care Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市妇幼保健院儿科一区,河南焦作454000 [2]焦作市妇幼保健院重症儿科,河南焦作454000

出　　处：《社区医学杂志》2022年第12期698-701,共4页Journal Of Community Medicine

摘　　要：目的探讨高频振动排痰在重症肺炎机械通气患儿呼吸道清理中的应用价值。方法选取2018-07-01-2020-09-01焦作市妇幼保健院收治的89例重症肺炎机械通气患儿作为研究对象,按照随机数字表法分为观察组(n=45)和对照组(n=44)。对照组给予人工扣背排痰,观察组给予高频振动排痰,对比干预后2组患者相关指标、呼吸功能、氧合状态。采用SPSS 22.0对数据进行统计学分析。结果干预后,观察组排痰量为(50.12±4.28)mL,高于对照组的(35.67±7.14)mL,F=11.548,P<0.001;机械通气时间为(87.52±11.20)h,短于对照组的(120.47±10.25)h,F=14.469,P<0.001;用力肺活量为(3.68±0.82)L,高于对照组的(3.06±0.63)L,F=3.993,P<0.001;第1秒用力呼出量为(2.60±0.72)L,高于对照组的(2.15±0.67)L,F=3.051,P=0.003;呼气流量峰值动态顺应性(Cydn)水平为(35.12±1.86)mL/cm H_(2)O,高于对照组的(27.83±3.24)mL/cm H_(2)O,F=12.979,P<0.001;二氧化碳分压(PaCO_(2))水平为(32.62±9.63)mm Hg,低于对照组的(44.79±7.54)mm Hg,F=6.628,P<0.001;氧合指数(PaO_(2)/FiO_(2))为(370.21±26.37)mm Hg,高于对照组的(311.58±40.29)mm Hg,F=8.103,P<0.001。结论高频振动排痰应用于重症肺炎机械通气患儿排痰及改善呼吸功能和氧合状态效果显著。Objective To explore the application value of high-frequency vibration expectoration in the airway clearance of children with severe pneumonia on mechanical ventilation.Methods From July 1,2018 to September 1,2020,89 children with severe pneumonia mechanically ventilated in Jiaozuo Maternal and Child Health Care Hospital were selected as the research objects,and divided into two groups according to the random number table method.Among them,44 patients in the control group were given artificial back buckles.For sputum excretion,45 cases in the observation group were given high-frequency vibration to expel sputum.The related indicators,respiratory function and oxygenation status of the two groups of patients were compared after the intervention,and the data were processed by SPSS 22.0 statistical software.Results After the intervention,the sputum volume of the observation group was(50.12±4.28)ml higher than that of the control group(35.67±7.14)ml,F=11.548,P<0.001,and the mechanical ventilation time(87.52±11.20)h was shorter than that of the control group(120.47±10.25)h,F=14.469,P<0.001,the forced vital capacity of the observation group was(3.68±0.82)L higher than that of the control group(3.06±0.63)L,F=3.993,P<0.001,the forced expiratory volume in the first second((2.60±0.63)0.72)L was higher than that of the control group(2.15±0.67)L,F=3.051,P=0.003,and the dynamic compliance of peak expiratory flow(Cydn)(35.12±1.86)ml/cm H_(2)O was higher than that of the control group(27.83±3.24)ml/cm H_(2)O,F=12.979,P<0.001,the partial pressure of carbon dioxide(PaCO_(2))in the observation group(32.62±9.63)mm Hg was lower than that in the control group(44.79±7.54)mm Hg,F=6.628,P<0.001,the oxygenation index(PaO_(2)/FiO_(2))(370.21±26.37)mm Hg was higher than that of the control group(311.58±40.29)mm Hg,F=8.103,P<0.001.Conclusion High-frequency vibration expectoration is effective in expelling sputum and improving respiratory function and oxygenation in children with severe pneumonia who are mechanically ventilated.

关 键 词：高频振动排痰 人工扣背排痰 重症肺炎机械通气 呼吸道清理 氧合状态 

分 类 号：R725.6[医药卫生—儿科]