摘要
目的探讨超声监测下呼吸肌训练对慢性阻塞性肺疾病急性期(AECOPD)行机械通气的患者膈肌功能与撤机的临床影响。方法选取我院2016年2月至2019年2月接收的AECOPD行机械通气患者80例作为研究对象,按数字奇偶法等分为对照组和研究组,对照组给予机械通气常规护理,使PEEP值与呼吸机压力值逐渐降低,根据经验撤机;研究组在超声监测下进行呼吸肌训练,比较两组患者训练前后膈肌功能变化、撤机成功率以及机械通气时间、呼吸肌锻炼不良事件发生情况。结果两组患者训练前呼、吸气末膈肌厚度、膈肌增厚分数比较差异均无统计学意义(P>0.05),训练后吸气末膈肌厚度、膈肌增厚分数组内及组间比较差异有统计学意义(P<0.05);研究组患者机械通气时间明显短于对照组(P<0.05);研究组撤机成功率高于对照组,但差异无统计学意义(P>0.05);研究组在进行超声监测下呼吸肌训练期间无不良事件发生。结论对AECOPD患者在超声监测下进行呼吸肌训练,可增加膈肌厚度,缩短机械通气时间,不影响撤机成功率,且安全性较高,值得临床应用推广。
Objective To discuss the clinical influence of respiratory muscle training under ultrasound monitoring for diaphragm function and weaning of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)mechanical ventilation.Methods To select 80 cases of patients with AECOPD who received mechanical ventilation in our hospital from February 2016 to February 2019 as the study objects.They were divided into a control group and a study group according to the digital parity method.The control group was given conventional nursing with mechanical ventilation,we made the PEEP value and the ventilator pressure value gradually to decrease,and we withdrew based on experience.The study group adopted respiratory muscle training under ultrasound monitoring.The changes of diaphragm function,the success rate of weaning,mechanical ventilation time,and adverse events in respiratory muscle exercise before and after training were compared between the two groups.Results Before training,there was no significant difference in end-expiratory and end-inspiratory diaphragmatic thickness,and diaphragmatic thickening scores between the two groups(P>0.05).After training,there were statistical significance in difference that the end-inspiratory diaphragmatic thickness and diaphragmatic thickening scores in internal groups and between groups(P<0.05).The mechanical ventilation time in the study group was significantly shorter than that in the control group(P<0.05).The success rate of weaning in the study group was higher than that in the control group,but the difference was not statistically significant(P>0.05).The study group had no adverse events during respiratory muscle training under ultrasound monitoring.Conclusion Respiratory muscle training for patients with AECOPD under ultrasound monitoring could increase diaphragmatic thickness,shorten mechanical ventilation time,do not affect the success rate of weaning,and have high safety,which was worthy of clinical application and promotion.
作者
景阅雯
李建华
李婷
JING Yue-wen;LI Jian-hua;LI Ting
出处
《护理实践与研究》
2020年第1期1-3,共3页
Nursing Practice and Research
关键词
慢性阻塞性肺疾病急性期
超声监测
膈肌功能
撤机
临床影响
Acute exacerbation of chronic obstructive pulmonary disease
Ultrasound monitoring
Diaphragm function
Weaning
Clinical effect
