咳痰机治疗对ICU获得性衰弱患者排痰效能的影响  

Effects of CoughAssist therapy on sputum excretion efficacy among patients with intensive care unit-acquired weakness

作　　者：吴娟 石泽亚[1] 宋英[1] 刘慧卿[1] 陈诚 徐晓平[1] 杨继平[1] 胡婉琴 谭秋红 Wu Juan;Shi Zeya;Song Ying;Liu Huiqing;Chen Cheng;Xu Xiaoping;Yang Jiping;Hu Wanqin;Tan Qiuhong(Nursing Department,Hu'nan Provincial People's Hospital,Changsha 410005,China)

机构地区：[1]湖南省人民医院护理部,长沙410005

出　　处：《中华现代护理杂志》2019年第1期101-104,共4页Chinese Journal of Modern Nursing

基　　金：长沙市科技计划项目(kq1706034).

摘　　要：目的探讨咳痰机对ICU获得性衰弱患者的排痰效能。方法采用方便抽样法,选取2016年1月—2017年12月湖南省人民医院ICU诊断为ICU获得性衰弱患者(ICU-AW)的84例机械通气患者,按随机数字表法分为对照组和观察组,每组各42例。两组患者均接受常规治疗及护理,观察组在接受常规治疗及护理的基础上增加咳痰机治疗。比较两组患者排痰效果、痰涂片/培养结果、血气指标、呼吸力学指标、VAP发生率、机械通气时间、ICU住院日、医学研究理事会(MRC)评分情况。结果两组患者入组前排痰量差异无统计学意义(P>0.05)。治疗后观察组第1~3天排痰量多于对照组,排痰显效的例数多于对照组,痰培养阳性率低于对照组,差异有统计学意义(P<0.05);观察组氧分压高于对照组,二氧化碳分压低于对照组,差异有统计学意义(P<0.05);压力支持/控制和气道阻力低于对照组,肺顺应性和咳嗽峰流速高于对照组,差异有统计学意义(P<0.01);观察组VAP发生率、机械通气时间和ICU住院日均低于对照组,差异有统计学意义(P<0.05);但两组MRC评分差异无统计学意义(P>0.05)。结论咳痰机在机械通气的ICU-AW患者中应用,可提升排痰效果,改善呼吸功能,缩短机械通气时间及ICU住院日,提高临床疗效。Objective To explore effects of CoughAssist on sputum excretion efficacy among patients with intensive care unit-acquired weakness (ICU-AW). Methods From January 2016 to December 2017, we selected 84 ICU-AW patients with mechanical ventilation of ICU in Hu'nan Provincial People's Hospital by convenience sampling. All of the patients were divided into control group and observation group with the random number table, 42 cases in each group. Two groups all received routine treatment and nursing. On this basis, observation group carried out CoughAssist therapy. We compared the sputum excretion effects, results of sputum smear/sputum culture, arterial blood gas indexes, respiratory mechanics indexes, the incidence of ventilator-associated pneumonia (VAP), time of mechanical ventilation, hospital days in ICU and the score of Medical Research Council (MRC) of patients between two groups. Results There were no statistical difference in the volume of sputum excretion of patients in two groups before dividing groups (P>0.05). One to three days after treatment, the volume of sputum excretion and number of effective sputum excretion patients in observation group were more than those in control group;the positive rate of sputum culture of patients in observation group was lower than that in control group;the differences were all statistical (P<0.05). The partial pressure of oxygen (PaO2) of observation group was higher than that of control group;the partial pressure of carbon dioxide (PaCO2) of observation group was lower than that of control group;the differences were all statistical (P<0.05). The pressure support/pressure control (PS/PC) and airway resistance of observation group were lower than those of control group;and the compliance and cough peak flow (PCF) were higher than those of control group with statistical differences (P<0.01). The incidence of VAP, time of mechanical ventilation and hospital days in ICU of observation group were lower than those of control group (P<0.05). There was no statistical difference in

关 键 词：呼吸 人工 ICU获得性衰弱 咳痰机 排痰 

分 类 号：R472.2[医药卫生—急诊医学]