分期呼吸训练在高位脊髓损伤患者肺康复护理中的应用  

Application of staged respiratory training in pulmonary rehabilitation nursing of patients with high spinal cord injury

作　　者：杨敏 刘朝晖 王志杰 王永超 蒋玮 Yang Min;Liu Zhaohui;Wang Zhijie;Wang Yongchao;Jiang Wei(Department of Rehabilitation Medicine,the Second Affiliated Hospital of Air Force Military Medical University,Xian 710038,China; Department of Nursing,the Second Affiliated Hospital of Xi'an Air Force Military Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院康复医学科,西安710038 [2]空军军医大学第二附属医院护理部,西安710038

出　　处：《中国实用护理杂志》2021年第27期2134-2139,共6页Chinese Journal of Practical Nursing

基　　金：空军军医大学第二附属医院护理科研课题(TDHLKY-2019-02)。

摘　　要：目的探讨分期呼吸训练在高位脊髓损伤患者肺康复护理中的应用效果。方法选取空军军医大学第二附属医院康复医学科2018年1月至2019年12月住院的高位脊髓损伤患者76例作为研究对象,采用随机数字表法分为对照组和观察组各38例。对照组给予常规呼吸训练,观察组接受分期呼吸训练。2组均每周干预6 d,连续干预8周。比较2组患者干预前后基础指标、肺通气功能、呼吸肌肌力指标及肺部感染发生率等指标的差异性。结果干预8周后观察组患者血氧饱和度为0.95±0.04,高于对照组的0.90±0.04,差异有统计学意义(t值为4.229,P<0.001);干预8周后观察组最大肺活量(VCmax)、用力呼气肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、最大通气量(MVV)占预计值的百分比分别为(69.21±11.38)、(61.83±11.53)、(56.50±7.86)、(51.62±8.73)%,均高于对照组的(56.70±14.65)、(49.82±15.06)、(45.61±10.32)、(42.30±15.11)%,差异有统计学意义(t值为3.610~4.967,P<0.001);观察组干预后吸气肌肌力指数(MIP)为(56.12±18.31)cmH_(2)O(1 cmH_(2)O=0.098 kPa),高于对照组的(46.61±11.62)cmH_(2)O,差异有统计学意义(t值为2.806,P<0.01);观察组肺部感染发生率为5.26%(2/38),虽低于对照组的15.78%(6/38),但差异无统计学意义(χ^(2)值为2.235,P>0.05)。结论分期呼吸训练可以促进高位脊髓损伤患者的肺康复,值得推广应用。Objective To explore the effect of staged respiratory training in pulmonary rehabilitation nursing of patients with high spinal cord injury.Methods A total of 76 patients with high spinal cord injury in the Second Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2019 were selected as the study subjects,and were divided into the control group and the observation group with random number table method,38 cases each.The control group was given conventional respiratory training,while the observation group was given staged respiratory training.Both groups were intervened 6 days a week for 8 weeks.The differences of basic indexes,pulmonary ventilation function,respiratory muscle strength and incidence of pulmonary infection between the two groups before and after intervention were compared.Results After 8 weeks of intervention,the blood oxygen saturation was 0.95±0.04 in the observation group and 0.90±0.04 in the control group,there was significant difference(t value was 4.229,P<0.001).The percentages of predicted values of maximal vital capacity,forced expiratory vital capacity,forced expiratory volume in 1s,and maximal ventilation were(69.21±11.38)%,(61.83±11.53)%,(56.50±7.86)%,(51.62±8.73)%in the observation group after 8 weeks of intervention,and(56.70±14.65)%,(49.82±15.06)%,(45.61±10.32)%,(42.30±15.11)%in the control group,there was significant difference(t values were 3.610-4.967,P<0.001).The inspiratory muscle strength index was(56.12±18.31)cmH_(2)O(1 cmH_(2)O=0.098 kPa)in the observation group after intervention,and(46.61±11.62)cmH_(2)O in the control group,there was significant different(t value was 2.806,P<0.01).The incidence of pulmonary infection was 5.26%(2/38)in the observation group and 15.78%(6/38)in the control group,there was no significant difference(χ^(2) value was 2.235,P>0.05).Conclusions Stage respiratory training can promote lung rehabilitation of patients with high spinal cord injury,which is worthy of promotion and application.

关 键 词：高位脊髓损伤 肺功能 分期呼吸训练 肺康复 

分 类 号：R473.6[医药卫生—护理学]