膈肌起搏下体位引流在颈髓损伤气管切开患者中的应用  

Application of external diaphragm pacemaker with postural drainage treatment for cervical spinal cord injury patients with tracheotomy

作　　者：付金英[1] 章微微[1] 李学军[1] 王元姣[1] 

机构地区：[1]浙江省人民医院康复科, 杭州310014

出　　处：《中华现代护理杂志》2014年第6期655-658,共4页Chinese Journal of Modern Nursing

摘　　要：目的：观察体外膈肌起搏下体位引流治疗对颈髓损伤后气管切开患者的康复疗效。方法将2009-2012年收治的颈髓损伤气管切开患者50例，随机分为对照组和治疗组，每组各25例，对照组采用气管切开常规护理、辅助排痰、抗感染治疗及肢体功能锻炼等综合康复治疗，治疗组除上述治疗外，采用体外膈肌起搏下体位引流治疗，两组均治疗4周。观察两组患者治疗前及治疗后呼吸功能、肺部体征、咳痰能力及自我感觉舒适度等指标。结果治疗后，治疗组的SpO2、呼吸频率、PaO2、PaCO2分别为（96．72±1．89）％，（16．48±0．62）次/min，（85．15±0．43）mmHg，（39．65±0．41）mmHg，对照组分别为（93．83±2．11）％，（22．05±0．59）次/min，（74．80±0．29）mmHg，（33．11±0．45）mmHg，差异有统计学意义（t值分别为6．57，3．45，9．69，4．67；P＜0．05）；肺部听诊体征和咳痰能力评分分别为（2．74±0．27），（2．67±0．32）分，对照组分别为（2．22±0．33），（2．15±0．41）分，差异有统计学意义（t值分别为8．78，13．56；P＜0．01）；自我感觉舒适度改善程度明显优于对照组，差异有统计学意义（χ2＝8．86，P＜0．05）。结论体外膈肌起搏下体位引流用于颈髓损伤气管切开患者疗效肯定，值得推广。Objective To evaluate the clinical effects of external diaphragm pacemaker with postural drainage treatment for cervical spinal cord injury patients with tracheotomy .Methods Totals of 50 cervical spinal cord injury patients with tracheotomy , treated from 2009 to 2012 , were randomly divided into the research group （n=25） and the control group （n=25）.Patients in the control group were given routine nursing care and were assisted sputum excretion , and given anti-infection treatment and functional training .Patients in the research group , in additional to the regular treatment , were given external diaphragm pacemaker with postural drainage treatment .All the patients were treated for four weeks .The pulmonary ventilation function , lung auscultation, ability of expectoration and self-sensation were analyzed before and after treatment within each group.Results The pulmonary ventilation function of SpO2, respiratory rate, PaO2, and PaCO2 were （96.72 ± 1.89）%, （16.48 ±0.62） per min, （85.15 ±0.43）mmHg and （39.65 ±0.41）mmHg, respectively, in the research group, and （93.83 ±2.11）%, （22.05 ±0.59） per min, （74.80 ±0.29） mmHg and （33.11 ± 0.45）mmHg, respectively, in the control group, and the differences were statistically significant （ t =6.57, 3.45, 9.69, 4.67, respectively;P＆lt;0.05）.The grades of lung auscultation and ability of expectoration in the research group were （2.74 ±0.27） and （2.67 ±0.32）, which were significantly higher than those of control group [（2.22 ±0.33） and （2.15 ±0.41）], with significant differences （t=8.78,13.56,respectively; P＆lt;0.01）.The improvement of the self-sensation in the research group was better than that in the control group （χ2 =8.86, P＆lt;0.05）.Conclusions The external diaphragm pacemaker with postural drainage treatment has obvious better effect for the cervical spinal cord injury patients with tracheotomy , and it is worthy of generalizing .

关 键 词：引流 体位 体外膈肌起搏 颈髓损伤 气管切开 

分 类 号：R473.6[医药卫生—护理学]