主动循环呼吸技术在脑卒中相关性肺炎气管切开患者治疗中的临床价值研究  

Study on the clinical value of active circulatory breathing technique in the treatment of patients with stroke-related pneumonia after tracheotomy

作　　者：刘翠[1] 甄巧霞[1] 齐琳[1] 王平 刘爱贤[1] LIU Cui;ZHEN Qiao-xia;QI Lin(Department of Neurological Rehabilitation,Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100041,China.)

机构地区：[1]首都医科大学附属北京康复医院神经康复中心,北京100041

出　　处：《中国医学装备》2022年第4期114-117,共4页China Medical Equipment

摘　　要：目的:研究主动循环呼吸技术在促进脑卒中相关性肺炎气管切开患者治疗中的临床应用价值。方法:选取医院收治的60例卒中相关性肺炎气管切开患者,采用随机数表法将其分为对照组和观察组,每组30例。对照组在常规治疗的基础上联合振动排痰治疗;观察组在常规治疗的基础上联合主动循环呼吸技术训练,两组均持续治疗8周。比较两组治疗前与治疗后8周感染中的全血白细胞计数(WBC)、血降钙素原(PCT)水平以及两组最大吸气压(MIP)、吸气流速峰值(PIF)水平;两组日常生活活动(ADL)能力评定量表评分,治疗8周后的肺炎改善、误吸发生及拔除气管套管情况。结果:治疗8周后,观察组总有效率及肺炎改善、拔除气管套管患者占比均高于对照组,差异有统计学意义(χ^(2)=5.192,χ^(2)=9.774,χ^(2)=7.954;P<0.05),误吸患者占比低于对照组,差异有统计学意义(χ^(2)=5.455,P<0.05)。治疗8周后,两组患者全血WBC、PCT水平均低于治疗前,且观察组低于对照组,差异有统计学意义(t=0.120,t=1.063;P<0.05);两组MIP、PIF水平均高于治疗前,且观察组高于对照组,差异有统计学意义(t=0.181,t=0.224;P<0.05);两组ADL能力评分均高于治疗前,但两组比较无统计学差异。结论:脑卒中相关性肺炎气管切开患者经主动循环呼吸技术治疗后,其感染情况得到有效控制,呼吸功能得到改善,康复训练使患者日常生活活动能力明显提高,其临床疗效显著。Objective:To analyze the clinical application value of active circulatory breathing technique in promoting the treatment of patients with stroke-associated pneumonia after stroke tracheotomy.Methods:60 patients with stroke-related pneumonia treated by tracheotomy were selected.And they were divided into control group and observation group by random number table method,with 30 patients in each group.Patients of control group were treated by vibration sputum extraction on the basis of conventional treatment.And patients of observation group were treated by active circulatory breathing technique training on the basis of conventional treatment.Both two groups were continually treated for 8 weeks.The levels of white blood cells(WBC),procalcitonin(PCT),the maximum inspiratory pressure(MIP)and the peak inspiratory flow(PIF)in infection before and after 8 weeks of treatment between two groups were compared.The scores of Activity of Daily Living(ADL)Assessment Scale,the improvement of pneumonia,the occurrences of aspiration and extubation after 8 weeks of treatment between two groups were further compared.Results:After 8 weeks of treatment,the total effective rate,and the proportions of pneumonia improvement and tracheal tube removal of patients in observation group were significantly higher than those in control group,the differences of them between two groups were statistically significant(χ^(2)=5.192,χ^(2)=9.774,χ^(2)=7.954,P<0.05),and the proportion of patients with aspiration in observation group was significantly lower than that in control group,and the difference of that between two groups was statistically significant(χ^(2)=5.455,P<0.05).And the levels of WBC and PCT in whole blood of the two groups after 8 weeks of treatment were significantly lower than those before treatment,and those of observation group were significantly lower than them of control group(t=0.120,t=1.063,P<0.05).The levels of MIP and PIF in two groups after 8 weeks of treatment were higher than those before treatment,and those in observati

关 键 词：脑卒中 脑卒中相关性肺炎 气管切开术 主动循环呼吸技术 康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]