COPD急性加重老年患者拔管后行主动循环呼吸联合振动正压呼气训练效果观察  

Effect of active cycle of breathing technique combined with oscillating positive expiratory pressure training in elderly patients with acute exacerbation of COPD after extubation

作　　者：文丹 梁拯华 杨秀茹 万丽[1] 何海燕[1] Wen Dan;Liang Zhenghua;Yang Xiuru;Wan Li;He Haiya(Intensive Care Unit,Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]绵阳市中心医院重症医学科,四川绵阳621000

出　　处：《护理学杂志》2024年第2期6-9,共4页Journal of Nursing Science

基　　金：绵阳市中心医院院级课题项目(2022YJ012)。

摘　　要：目的探讨慢性阻塞性肺疾病急性加重(Acute Exacerbation of Chronic Obstructive Pulmonary Disease,AECOPD)老年患者拔管后应用主动循环呼吸技术联合振动正压呼气技术行呼吸功能训练的效果。方法将收治于重症医学科及呼吸内科监护室的72例AECOPD老年患者随机分为对照组(35例)与试验组(37例),对照组气管插管拔管后采用主动循环呼吸技术进行呼吸功能训练,试验组在主动循环呼吸技术基础上联合振动正压呼气技术进行呼吸功能训练,比较两组拔管后48 h内再次气管插管事件、咳嗽咳痰及呼吸困难症状改善情况、肺功能及血气指标。结果两组48 h内再次气管插管率比较差异无统计学意义(P>0.05)。干预后试验组咳嗽咳痰评分、呼吸困难评分显著低于对照组,PaO 2显著高于对照组,而PaCO 2显著低于对照组(均P<0.05);试验组拔管后ICU停留时间显著短于对照组(P<0.05)。结论对AECOPD老年患者增加振动正压呼气技术辅助呼吸功能训练,可以有效促进呼吸道分泌物排出,改善临床症状,缩短ICU住院时间。Objective To explore the application effect of active cycle of breathing technique combined with oscillating positive expiratory pressure technique in respiratory function training among elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)after extubation.Methods A total of 72 elderly patients with AECOPD after extubation in the intensive care unit and respiratory medicine intensive care unit were randomized into a control group(n=35)and an experimental group(n=37).The control group was treated with active cycle of breathing technique when conducting respiratory function training,while the experimental group additionally combined with oscillating positive expiratory pressure technique.The incidence of re-intubation within 48 hours after extubation,the improvement of cough,sputum and dyspnea,lung function and blood gas indexes were compared between the two groups.Results There wasn′t statistically significant difference in re-intubation rate between the two groups(P>0.05).The scores of cough,sputum and dyspnea in the experimental group were significantly lower than those in the control group,its PaO 2 was significantly higher than that of the control group,and its PaCO 2 was significantly lower than that of the control group(all P<0.05).The ICU stay duration after extubation in the experimental group was significantly shorter than that in the control group(P<0.05).Conclusion For elderly patients with AECOPD after extubation,the auxiliary respiratory function training of oscillating positive expiratory pressure technique can effectively promote their evacuation of respiratory secretions,improve clinical symptoms and shorten their duration of stay in ICU.

关 键 词：老年人 慢性阻塞性肺疾病 正压呼气 气管插管 主动循环呼吸技术 振动正压呼气技术 呼吸功能训练 

分 类 号：R473.5[医药卫生—护理学] R339.34[医药卫生—临床医学]