医护治一体化康复模式在脑卒中气管切开患者肺康复中的应用  

Application of integrated rehabilitation model of medical care and treatment in pulmonary rehabilitation of stroke patients with tracheotomy

作　　者：李敏[1] 蹇斯荣[1] 耿洪燕[1] 李雪梅[1] LI Min;JIAN Sirong;GENG Hongyan;LI Xuemei(Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China)

机构地区：[1]滨州医学院附属医院,山东滨州256603

出　　处：《滨州医学院学报》2024年第2期137-141,共5页Journal of Binzhou Medical University

基　　金：滨州医学院附属医院护理科研项目(BYFYHL-202106)。

摘　　要：目的探讨医护治一体化康复模式在脑卒中气管切开患者肺康复中的应用效果。方法选取2021年7月1日至2022年6月31日康复医学科收治的脑卒中气管切开患者48例作为研究对象,其中2021年12月31日之前收治的24例作为对照组,之后收治的24例作为试验组。两组患者均给予康复医学科常规康复干预措施,试验组在此基础上进行医护治一体化康复模式管理,观察时间均为4周。两组患者在入院当天及护理干预4周后分别测定用力肺活量(FVC)、1秒用力呼气量(FEV1)、呼气峰值流速(PEF),膈肌厚度及移动度,比较两组患者护理干预4周后肺部感染发生率、抗菌药物使用时间、气管套管拔管率及出院时的满意度。结果两组患者护理干预4周后FVC、FEV1、PEF、膈肌厚度和膈肌平静呼吸移动度均大于入院当天,P<0.05或<0.01;且试验组护理干预4周后的FVC、FEV1、PEF、膈肌厚度和膈肌平静呼吸移动度均大于对照组,P<0.05。护理干预4周后,与对照组比较,试验组肺部感染发生率降低,P<0.05,抗菌药物使用时间缩短,P<0.01。试验组出院当天满意度(91.7%)高于对照组满意度(83.3%),但差异无统计学意义。结论医护治一体化康复模式能有效改善脑卒中气管切开患者的肺功能,降低肺部感染发生率,从而提高患者生活质量,康复干预效果满意,患者满意度高。Objective To explore the application effect of integrated rehabilitation model of medical care and treatment in pulmonary rehabilitation of stroke patients with tracheotomy.Methods Forty-eight patients with stroke diagnosed by tracheotomy in the Department of Rehabilitation from July 1st,2021 to June 31st,2022 were selected as the research objects.Patients admitted before December 31st,2021 were selected as the control group,and patients admitted after that were selected as the experimental group.Patients in the two groups were given routine treatment and nursing in the department,and patients in the experimental group were given integrated rehabilitation nursing on this basis.Both groups were observed for 4 weeks.Forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF),diaphragm thickness and activity were measured on the day of admission and 4 weeks after nursing intervention in both groups,and the incidence of pulmonary infection,antibiotic use time,tracheal tube extubation rate and satisfaction at discharge were compared between the two groups after 4 weeks of nursing intervention.Results After 4 weeks of nursing intervention,FVC,FEV1,PEF,diaphragm thickness and diaphragm calm breathing mobility were all higher than on the day of admission in both groups,P<0.05 or<0.01;After 4 weeks of nursing intervention,compared with that in the control group,the incidence of pulmonary infection in the experimental group decreased,P<0.05,and the duration of antibiotic use reduced,P<0.01.The satisfaction of the experimental group(91.7%)was higher than that of the control group(83.3%),but the difference was not statistically significant.Conclusion The integrated rehabilitation management model can effectively improve the pulmonary function of stroke patients with pulmonary dysfunction,and reduce the incidence of pulmonary infection,so as to improve the quality of life of patients.The effect of rehabilitation intervention was satisfactory and the patient satisfaction was high.

关 键 词：脑卒中 肺康复 医护治一体化康复模式 

分 类 号：R473.5[医药卫生—护理学]