物理疗法辅助治疗高血压脑出血术后肺部感染的随机、对照、开放研究  

A randomized controlled open⁃label study of physiotherapy combined with conventional western medicine on pulmonary infection after hypertensive cerebral hemorrhage

作　　者：张花平 宋贺[1] 张博[2] 马晓玲 ZHANG Huaping;SONG He;ZHANG Bo;MA Xiaoling(Department of Intensive Medicine,Shijiazhuang NO.1 Hospital,Shijiazhuang,Hebei 050000,China;Third Department of Neurosurgery,Shijiazhuang NO.1 Hospital,Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市第一医院重症医学科,河北石家庄050000 [2]石家庄市第一医院神经外三科,河北石家庄050000

出　　处：《安徽医药》2020年第12期2382-2386,共5页Anhui Medical and Pharmaceutical Journal

基　　金：石家庄市科技局科技支撑计划项目(171462303).

摘　　要：目的探讨物理疗法配合常规药物对高血压脑出血(HICH)术后肺部感染的治疗效果。方法选取2018年2月至2019年7月于石家庄市第一医院行HICH手术并发肺部感染的病人106例,按随机数表法分为观察组54例,对照组52例,对照组接受常规药物治疗(抗感染+氨溴索等),观察组在对照组基础上接受物理疗法(机械辅助排痰、雾化治疗、有效咳嗽训练、缩唇呼吸训练、呼吸训练器治疗和肺活量训练),均连续治疗12 d。对比两组治疗后咳嗽、肺部啰音、呼吸困难症状消失时间,比较两组治疗前后肺功能指标[第1秒用力呼气容积(FEV1)、FEV1占预测值百分比(FEV1%pred)、FEV1占用力肺活量百分比(FEV1/FVC%)]、两组抗肺部感染的临床疗效。结果因死亡剔除、终止3例,最终观察组53例,对照组50例。观察组咳嗽、肺部啰音、呼吸困难症状消失时间均短于对照组(P<0.001);两组治疗后FEV1、FEV1%pred、FEV1/FVC%均升高(P<0.05),且观察组均更高(P<0.05);两组抗肺部感染临床疗效等级分布差异有统计学意义(P<0.05),观察组总有效率94.34%(50/53)高于对照组72.00%(36/50)(P<0.05)。结论物理疗法配合常规药物治疗可有效缩短HICH术后肺部感染病人咳嗽、肺部啰音、呼吸困难症状的恢复时间,促进病情恢复,提高病人肺功能,具有较好的抗肺部感染临床疗效。Objective To explore the therapeutic effect of physiotherapy combined with conventional western medicine on pulmo⁃nary infection after hypertensive cerebral hemorrhage(HICH).Methods The106 patients with complicated pulmonary infection af⁃ter HICH operation in Shijiazhuang NO.1 Hospital from February 2018 to July 2019 were selected and randomly assigned into ob⁃servation group(54 cases)and control group(52 cases)according to the random number table method.The control group received conventional medicine treatment(anti⁃infective and ambroxol etc.).And the observation group received an additional physical therapy(mechanically assisted sputum removal,atomization therapy,effective cough training,labial contraction breathing training,breath⁃ing trainer therapy and lung capacity training).All treatments lasted for 12 d.After treatment,the disappearance time of cough,lung rales and dyspnea symptoms in the two groups were compared.Besides,pulmonary function indexes before and after treatment in the two groups were compared,including forced expiratory volume in one second(FEV1),FEV1 percentage of predicted value(FEV1%pred),FEV1%percentage of forced vital capacity(FEV1/FVC%),and clinical efficacies of anti⁃pulmonary infection in the two groups were compared.Results Three cases were excluded due to death.The final numbers of cases in the observation group and the control group were 53 and 50,respectively.The disappearance time of cough,lung rales and dyspnea in the observation group was shorter than that in the control group(P<0.001).FEV1,FEV1%pred and FEV1/FVC%were increased in both groups af⁃ter treatment(P<0.05),which were all higher in the control group(P<0.05).There was a significant difference in the distribution of clinical efficacies of anti⁃pulmonary infection between the two groups(P<0.05),and the total effective rate in the observation group was higher than that in the control group[94.34%(50/53)vs.72.00%(36/50),P<0.05].Conclusion Physical therapy combined with conventional western medicine can eff

关 键 词：颅内出血 高血压性 呼吸道感染 物理疗法 最大呼气流量⁃容积曲线 肺活量 氨溴索 

分 类 号：R651.12[医药卫生—外科学]