阶梯式肺康复护理方案在呼吸衰竭患者中的应用效果研究  

Study on the effect of progressive pulmonary rehabilitation program in patients with respiratory failure

作　　者：张梦 徐素琴[1] ZHANG Meng;XU Suqin

机构地区：[1]华中科技大学同济医学院附属同济医院呼吸与危重症医学科,武汉市430030

出　　处：《中华急危重症护理杂志》2023年第4期304-308,共5页Chinese Journal of Emergency and Critical Care Nursing

基　　金：同济医院科研基金(2021D15)。

摘　　要：目的探讨阶梯式肺康复护理方案对呼吸衰竭患者的实施效果。方法采用类实验研究设计方法,便利选取武汉市某三级甲等医院呼吸重症监护室2021年1月—2022年9月收治的48例呼吸衰竭患者作为试验组,采用阶梯式肺康复护理方案;2019年1月—2020年12月收治的43例呼吸衰竭患者作为对照组,采用常规肺康复。比较两组的肺功能指标、机械通气时间、脱机时间、脱机后48 h内再插管率、病死率的差异。结果试验组机械通气时间(Z=-2.982,P=0.003)和脱机时间明显缩短(Z=-4.189,P<0.001),脱机后48 h内再插管率降低(χ^(2)=-4.501,P=0.034),肺功能改善(P<0.05),病死率差异无统计学意义(χ^(2)=0.052,P=0.819)。结论阶梯式肺康复护理方案有助于改善患者肺功能,缩短机械通气时间,降低拔管后再插管率。Objective To explore the implementation effect of the progressive pulmonary rehabilitation program on patients with respiratory failure.Methods A quasi-experimental research design was adopted.48 patients with respiratory failure from January 2021 to September 2022 were selected as the intervention group and the progressive pulmonary rehabilitation program was adopted.43 patients with respiratory failure from January 2019 to December 2020 were selected as the control group and routine pulmonary rehabilitation was implemented.Compare lung function index,mechanical ventilation time,ventilator weaning time,reintubation rate within 48 hours after weaning,and death outcome between the two groups.Results In the intervention group,the mechanical ventilation time(Z=-2.982,P=0.003)and ventilator weaning time(Z=-4.189,P<0.001)were significantly shortened,the reintubation rate within 48 hours after weaning was reduced(χ^(2)=-4.501,P=0.034),the lung function improved(P<0.05),but there was no significant difference in death outcome(χ^(2)=0.052,P=0.819).Conclusion The progressive pulmonary rehabilitation program can improve the lung function of patients,shorten the time of mechanical ventilation,and reduce the rate of reintubation after weaning.

关 键 词：呼吸功能不全 肺康复 呼吸 人工 危重病护理 

分 类 号：R473.5[医药卫生—护理学]