早期心理干预配合呼吸康复训练在严重呼吸机依赖患者脱机前治疗中的作用  

Effects of Early Psychological Intervention Combined with Respiratory Rehabilitation Training in the Treatment of Severe Ventilator-dependent Patients Before Weaning

作　　者：李俊红[1] 王丛欢 李坤 武丽萍[1] 宇文霞 周彩霞[1] LI Junhong;WANG Conghuan;LI Kun(Department of Respiratory Medicine,First Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]中国河北医科大学第一医院呼吸内科(河北石家庄),050031 [2]河北省行唐县中医院功能科,050600

出　　处：《中国健康心理学杂志》2018年第9期1314-1318,共5页China Journal of Health Psychology

摘　　要：目的：探讨早期心理干预配合呼吸康复训练在严重呼吸机依赖患者脱机前治疗中的作用。方法：80例严重呼吸机依赖患者随机分为实验组和对照组各40例,对照组给予常规脱机治疗与呼吸康复训练,实验组在对照组基础上强化心理干预治疗。比较两组脱机情况,呼吸、血气及心理状态。结果：实验组1周、2周成功脱机率（70.00%、90.00%）明显高于对照组（47.50%、70.00%）,脱机时间明显较对照组短,差异有统计学意义（χ2=4.18,5.00;t=4.04;P〈0.05）。两组干预后心率、呼吸频率及动脉血二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）均较干预前明显改善（t（实验组）=11.23,9.92,11.33,-11.56;t（对照组）=8.22,7.75,10.40,-10.48;P〈0.01）,但与对照组相比,实验组心率、呼吸频率及PaCO2显著较低,PaO2明显较高（t=-8.79,-5.26,-8.18,3.11;P〈0.05）。两组干预后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分均较干预前明显降低（t（实验组）=11.41,11.61;t（对照组）=9.98,10.82,P〈0.01）,但实验组SAS、SDS评分显著低于对照组（t=-5.65,-4.59;P〈0.01）。结论：在严重呼吸机依赖患者脱机前治疗中,早期心理干预配合呼吸康复训练有助于缩短脱机时间、短期内提高脱机成功率,并对改善呼吸、血气及负面情绪状态有积极作用。Objective：To explore the effects of early psychological intervention combined with respiratory rehabilitation training in the treatment of severe ventilator-dependent patients before weaning.Methods：A total of 80 severe ventilator-dependent patients were randomly divided into the experimental group and the control group with 40 patients in each group.The control group was given routine weaning treatment and rehabilitation training while the experimental group was given intensive psychological intervention.The status of weaning,respiration,blood gas and mental status were compared between the two groups.Results：The success rates of weaning in the experimental group in 1 week and 2 weeks（70.00%,90.00%）were significantly higher than those in the control group（47.50%,70.00%）,and the weaning time was significantly shorter than that in the control group（χ2=4.18,5.00;t=4.04;P〈0.05）.After the intervention,the heart rate,respiratory rate,arterial partial pressure of carbon dioxide（PaCO2）and arterial partial pressure of oxygen（PaO2）in the two groups were significantly improved（texperimental group=11.23,9.92,11.33,-11.56,tcontrol group=8.22,7.75,10.40,-10.48;P〈0.01）.Compared with the control group,the heart rate,respiratory rate and PaCO2 were significantly lower while PaO2 was significantly higher in the experimental group（t=-8.79,-5.26,-8.18,3.11;P〈0.05）.After the intervention,scores of the Self-rating Anxiety Scale（SAS）and the Self-rating Depression Scale（SDS）in the two groups were significantly lower than those before the intervention（texperimental group=11.41,11.61,tcontrol group=9.98,10.82;P〈0.01）,but the scores in experimental group were significantly lower than those in the control group（t=-5.65,-4.59;P〈0.01）.Conclusion：The application of early psychological intervention combined with respiratory rehabilitation training in the treatment of severe ventilator-dependent patients before weaning can help shorten the weaning time,and improve the success rate o

关 键 词：呼吸机依赖 脱机 心理干预 呼吸康复训练 心理状态 

分 类 号：R395.9[哲学宗教—心理学]