胸部物理排痰干预联合阈值压力负荷呼吸肌训练对呼吸机依赖患者肺功能及呼吸机相关性肺炎预防的影响  

Effects of Chest Physical Sputum Expulsion Intervention Combined with Threshold Pressure Load Respiratory Muscle Training on Lung Function and VAP Prevention in Ventilators Dependent Patients

作　　者：马香 吕丹阳 王雪娥 MA Xiang;LYU Danyang;WANG Xue’e(Department of Intensive Care and Respiratory Rehabilitation,Xiamen Hongai Rehabilitation Hospital,Xiamen,Fujian 150060,China;Department of Cardiology,Gaomi Hospital of Traditional Chinese Medicine,Weifang,Shandong 261500,China)

机构地区：[1]厦门弘爱康复医院重症与呼吸康复科,福建厦门150060 [2]高密市中医院心内科,山东潍坊261500

出　　处：《中国医药指南》2025年第7期114-116,共3页Guide of China Medicine

摘　　要：目的探讨胸部物理排痰干预联合阈值压力负荷呼吸肌训练对呼吸机依赖患者的影响。方法回顾性分析2023年1月至2024年1月本院收治的80例呼吸机依赖患者的临床资料,根据干预方式的不同进行分组,其中实施常规干预的40例患者为对照组,实施胸部物理排痰干预联合阈值压力负荷呼吸肌训练的40例患者为观察组。对比两组肺功能、吸气肌功能、炎症指标、呼吸机相关性肺炎(VAP)发生率。结果观察组干预后的最大通气量、第一秒用力呼气容积、肺活量、吸气峰流速、最大吸气压水平均高于对照组,高迁移率蛋白B1、白细胞介素10、白细胞介素8水平均低于对照组(均P<0.05);观察组VAP发生率低于对照组(P<0.05)。结论在呼吸机依赖患者中应用胸部物理排痰干预联合阈值压力负荷呼吸肌训练干预效果显著,可促进肺部功能改善,减轻炎症反应,提高吸气肌功能,减少VAP发生风险。Objective To investigate the effect of chest physical sputum expulsion intervention combined with threshold pressure load respiratory muscle training on ventilators dependent patients.Methods Clinical data of 80 ventilators dependent patients admitted to our hospital from January 2023 to January 2024 were retrospectively analyzed,and divided into groups according to different intervention methods.40 patients who received routine intervention were included in the control group,and 40 patients who received chest physical expectoration intervention combined with threshold pressure load respiratory muscle training were included in the observation group.Lung function,inspiratory muscle function,inflammatory index and incidence of ventilator-associated pneumonia(VAP)were compared between the two groups.Results After intervention,the maximum gas volume,forced expiratory volume in the first second,vital capacity,peak inspiratory flow rate and maximum inspiratory pressure in observation group were higher than those in control group,and the levels of high mobility protein B1,interleukin-10 and interleukin-8 were lower than those in control group(all P<0.05).The incidence of VAP in observation group was lower than that in control group(P<0.05).Conclusions In ventilator dependent patients,the intervention of chest physical sputum expulsion combined with threshold pressure load respiratory muscle training has a significant effect,which can promote the improvement of lung function,reduce inflammation,improve inspiratory muscle function,and reduce the risk of VAP.

关 键 词：呼吸机依赖 阈值压力负荷呼吸肌训练 胸部物理排痰干预 肺功能 呼吸机相关性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]