翻身拍背对慢性阻塞性肺疾病患者机械通气拔管后肺部指征的影响  

作　　者：刘琼[1] 姜佳瑜[1] 陈春霞[1] 

机构地区：[1]上海交通大学附属瑞金医院RICU,上海200025

出　　处：《现代临床护理》2010年第6期16-17,15,共3页Modern Clinical Nursing

摘　　要：目的探讨翻身拍背对慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)患者机械通气拔管后肺部指征的影响。方法选择2008年12月-2009年12月在本院呼吸重症监护室(respiratory intensive care unit,RICU)住院并且需要行机械通气的COPD患者24例,随机分为实验组和对照组各12例。对照组采用常规护理方法进行排痰,实验组采用翻身拍背的方法协助患者排痰,比较两组患者排痰前后各项临床指标、咳嗽及啰音消退时间及二次插管率。结果两组患者排痰前后各项临床指标、咳嗽及啰音消退时间及二次插管率比较,均P<0.05,差异具有统计学意义,实验组排痰后各项临床指标优于对照组、咳嗽及啰音消退时间短于对照组、二次插管率低于对照组。结论翻身拍背对COPD患者机械通气拔管后痰液的引流有促进作用,可以提高治疗效果,降低二次插管率,促进患者康复。Objective To investigate the effect of body-turning and backslapping on sputum drainage after removal of mechanical ventilation in patients with chronic obstructive pulmonary diseases （COPD）. Methods 24 COPD patients hospitalized and managed with mechanical ventilation in RICU from December 2008 to December 2009 were randomly divided into the experimental and control group. In the control group, routine nursing intervention for expectoration was conducted, and in the experimental group body-turning and backslapping were used to help them with expectoration. The differences in clinical indexes, pulmonary symptoms and signs, and rate of reintubatian were compared between two groups before and after expectoration. Results There were significant differences between the two groups in clinical indexes, pulmonary symptoms and signs, and reintubation rate （P 〈 0.05）. The duration of cough-induced pulmonary rales was shorter and the reintubation rate was lower, compared to the control group. Conclusions Bedy-turning and backslapping after extubation in COPD patients can promote the sputum drainage, improve the therapeutic effect and reduce the reintubation rate. Thereby, it is conducive to rehabilitation of COPD patients.

关 键 词：翻身拍背 慢性阻塞性肺疾病 机械通气 拔管 护理 

分 类 号：R473.5[医药卫生—护理学]