脑出血患者肺部感染早期物理治疗的临床研究  

Clinical efficacy of early physical therapy in treatment of pulmonary infections in patients with cerebral hemorrhage

作　　者：崔莉[1] 杨爽[1] 李润辉[1] 

机构地区：[1]沈阳医学院附属中心医院神经内科,辽宁沈阳110024

出　　处：《中华医院感染学杂志》2014年第4期906-908,共3页Chinese Journal of Nosocomiology

基　　金：辽宁省卫生厅基金资助项目(2012225019)

摘　　要：目的探讨高龄脑出血患者早期肺部物理治疗降低肺部感染的临床疗效,为临床诊断治疗提供依据。方法选取2012年8月-2013年8月86例接受诊治的高龄脑出血患者,按照随机数字表法将其分为对照组与观察组,每组各43例;对照组在住院后1d开始吸痰、雾化吸入等常规治疗同时应用震动排痰器振肺后指导患者咳痰的肺部物理治疗方法,观察组在住院后2h开始进行肺部物理治疗,1d后进行肺部常规治疗;观察两组患者肺部感染率、病原体分布,治疗前后血氧饱和度、血压、住院天数及1、3d日均排痰量与有效排痰率;采用SPSS17.0软件对数据进行统计分析。结果 86例高龄脑出血患者发生肺部感染17例,感染率19.77%,其中观察组9.30%,对照组30.23%,两组肺部感染率差异有统计学意义(P<0.05);共检出病原体26株,其中细菌20株占76.92%、病毒2株占7.69%、衣原体属4株占15.39%;两组患者治疗后血氧饱和度均高于治疗前;1d日均排痰量观察组多于对照组;观察组1、3d有效排痰率分别为83.72%、93.02%,显著高于对照组的58.14%、76.74%;观察组住院天数(13.58±3.16)d,显著低于对照组的(22.14±3.25)d,差异有统计学意义(P<0.05)。结论早期肺部物理治疗降低高龄脑出血患者肺部感染,可缩短住院时间、降低肺部感染率,且操作安全,对控制医院感染具有重要临床意义。OBJECTIVE To explore the clinical efficacy of early physical therapy in treatment of pulmonary infections in aged patients with cerebral hemorrhage to provide basis for clinical treatment. METHODS A total of 86 aged patients with cerebral hemorrhage, who were hospitalzed from Aug 2012 to Aug 2013, were enrolled in the study and randomly divided into the control group and the observation group, with 43 cases in each. The control group was treated with conventional therapies such as suetioning and aerosol inhalation ] day after surgery, meanwhile, the vibration expectoration was performed. The pulmonary physical therapy was conducted in the observation group 2 hours after surgery, and the conventional therapy was performed 1 day after surgery. The incidence of pulmonary infections, distribution of pathogens, oxygen saturation before and after treatment, blood pressure, length of hospital stay, expectoration volume on the first and third day, and effective expectoration rate were observed and compared between the two groups, and the statistical analysis was performed with the SPSS17.0 software. RESULTS Of the 86 aged patients with cerebral hemorrhage, the pulmonary infection occurred in 17 cases with the infection rate of 19.77, the incidence of pulmonary infections 9.30/oo in the observation group, 30.23 in the control group. Totally 26 strains of pathogens isolated, including 20 （76.92） strains of pathogenic bacteria, 2 （7.69 ） strains of viruses, and 4 （15.39 ） strains of Chlamydia. The oxygen saturation of both groups significantly was higher after the treatment than before the treatment, with statistical significance （P0.05） ; the mean expectoration volume on the first day was more in the observation group than in the control group, with statistical significance （P%0.05）3 the effective expectoration rate on the first day was 83.72 % in theobservation group, significantly higher than 58.14 //00 in the control group; the effective expectoration rate on the third day was 93. 02 in the observat

关 键 词：高龄患者 脑出血 肺部感染 早期肺部物理治疗 

分 类 号：R563.1[医药卫生—呼吸系统]