目的探讨双水平气道正压通气(BiPAP)无创呼吸机通气联合肺康复治疗在老年护理机构慢性阻塞性肺疾病(COPD)稳定期合并高碳酸血症患者中的应用效果。方法选取2018年2月—2019年2月收治的47例老年COPD稳定期合并高碳酸血症接受肺康复的患者...目的探讨双水平气道正压通气(BiPAP)无创呼吸机通气联合肺康复治疗在老年护理机构慢性阻塞性肺疾病(COPD)稳定期合并高碳酸血症患者中的应用效果。方法选取2018年2月—2019年2月收治的47例老年COPD稳定期合并高碳酸血症接受肺康复的患者,采用随机数字表法随机分成研究组(n=23)和对照组(n=24)。对照组予低流量鼻导管吸氧、化痰、扩张支气管、布地奈德福莫特罗吸入剂、营养治疗、有氧训练、阻抗训练以及心理支持等治疗措施;研究组在对照组的治疗基础上联合给予无创BiPAP治疗。比较2组患者的临床疗效、血气指标、慢性阻塞性肺疾病评估测试(CAT)、6min步行试验(6MWT)、肺功能及并发症发生情况。结果治疗4周,研究组二氧化碳分压和6MWT的改善程度优于对照组,差异有统计学意义(P<0.05);研究组FEV1及FEV1占预计值百分比有所提升,且研究组改善情况优于对照组(P<0.05)。研究组临床疗效总有效率高于对照组(91.3% vs 62.5%,P=0.049),继发肺部感染的发生率低于对照组(26.1% vs 62.5%,P=0.037)。结论BiPAP无创呼吸机通气联合肺康复治疗在合并高碳酸血症的老年COPD稳定期患者中疗效显著,能有效改善患者的临床症状、血气指标及肺功能,降低二氧化碳潴留及呼吸性酸中毒,减少肺部感染的发生率。展开更多
OBJECTIVE:To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ)decoction for the treatment of constipation in acute ischemic stroke patients,and figure out the role that bowel movements play...OBJECTIVE:To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ)decoction for the treatment of constipation in acute ischemic stroke patients,and figure out the role that bowel movements play in the treatment of acute ischemic stroke.METHODS:A total of 317 eligible patients were recruited and randomized to the XLCQ group(211 patients)or the control group(106 patients).In addition to conventional standard medical care and rehabilitation,participants in the XLCQ group received XLCQ decoction,while the control group received clysis therapy using glycerin enemas or lactulose oral solution.Both groups were given treatment for 3 to 6 d,during which they received daily visits to record defecation features and accompanying symptoms.Neurological assessments using the National Institutes of Health Stroke Scale(NIHSS)were conducted before and 1 month after treatment.RESULTS:Patients in the XLCQ group had lower aggregate constipation scores compared with the control group on days 3 and 5(P<0.05).Spontaneous bowel movements tended to reappear more rapidly after taking the XLCQ decoction than after conventional laxative treatment.Both the average aggregate constipation score and the time taken to achieve spontaneous bowel movements showed positive correlations with NIHSS scores before and1 month after treatment(P<0.01).CONCLUSION:Treatment with XLCQ decoction effectively alleviated the overall symptoms of constipation in acute ischemic stroke patients.The status of bowel movements in acute ischemic stroke can reflect the severity of neurological impairment and predict neurological outcomes at 1 month.展开更多
文摘目的 探讨神经反射激活联合温差刺激口腔护理在脑卒中伴张口受限患者中的应用效果。方法 将80例脑卒中伴张口受限患者随机分为对照组40例与研究组40例。对照组采用纱布牙刷蘸取40℃口腔护理液擦拭法;研究组采用神经反射激活联合温差刺激式口腔护理(4℃无菌生理盐水棉签轻压K点激活三叉神经反射联合纱布牙刷蘸取40℃口腔护理液擦拭法)。干预24周,比较两组患者口腔健康状况(Brief Oral Health Status Examination,BOHSE)、口臭指数以及患者张口受限分级等情况。结果 研究组BOHSE及口臭指数优于对照组,差异有统计学意义(P<0.05);研究组治疗后张口受限分级优于治疗前,差异有统计学意义(P<0.05)。结论 神经反射激活联合温差刺激口腔护理对脑卒中伴张口受限患者护理效果显著,能改善脑卒中张口受限症状,改善口腔健康状况BOHSE,降低口臭指数,促进患者舒适。
文摘目的探讨双水平气道正压通气(BiPAP)无创呼吸机通气联合肺康复治疗在老年护理机构慢性阻塞性肺疾病(COPD)稳定期合并高碳酸血症患者中的应用效果。方法选取2018年2月—2019年2月收治的47例老年COPD稳定期合并高碳酸血症接受肺康复的患者,采用随机数字表法随机分成研究组(n=23)和对照组(n=24)。对照组予低流量鼻导管吸氧、化痰、扩张支气管、布地奈德福莫特罗吸入剂、营养治疗、有氧训练、阻抗训练以及心理支持等治疗措施;研究组在对照组的治疗基础上联合给予无创BiPAP治疗。比较2组患者的临床疗效、血气指标、慢性阻塞性肺疾病评估测试(CAT)、6min步行试验(6MWT)、肺功能及并发症发生情况。结果治疗4周,研究组二氧化碳分压和6MWT的改善程度优于对照组,差异有统计学意义(P<0.05);研究组FEV1及FEV1占预计值百分比有所提升,且研究组改善情况优于对照组(P<0.05)。研究组临床疗效总有效率高于对照组(91.3% vs 62.5%,P=0.049),继发肺部感染的发生率低于对照组(26.1% vs 62.5%,P=0.037)。结论BiPAP无创呼吸机通气联合肺康复治疗在合并高碳酸血症的老年COPD稳定期患者中疗效显著,能有效改善患者的临床症状、血气指标及肺功能,降低二氧化碳潴留及呼吸性酸中毒,减少肺部感染的发生率。
基金Supported by the National Science and Technology Pillar Program during the 12th Five-year Plan Period of the People’s Republic of China(No.2013BAI13B02).
文摘OBJECTIVE:To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ)decoction for the treatment of constipation in acute ischemic stroke patients,and figure out the role that bowel movements play in the treatment of acute ischemic stroke.METHODS:A total of 317 eligible patients were recruited and randomized to the XLCQ group(211 patients)or the control group(106 patients).In addition to conventional standard medical care and rehabilitation,participants in the XLCQ group received XLCQ decoction,while the control group received clysis therapy using glycerin enemas or lactulose oral solution.Both groups were given treatment for 3 to 6 d,during which they received daily visits to record defecation features and accompanying symptoms.Neurological assessments using the National Institutes of Health Stroke Scale(NIHSS)were conducted before and 1 month after treatment.RESULTS:Patients in the XLCQ group had lower aggregate constipation scores compared with the control group on days 3 and 5(P<0.05).Spontaneous bowel movements tended to reappear more rapidly after taking the XLCQ decoction than after conventional laxative treatment.Both the average aggregate constipation score and the time taken to achieve spontaneous bowel movements showed positive correlations with NIHSS scores before and1 month after treatment(P<0.01).CONCLUSION:Treatment with XLCQ decoction effectively alleviated the overall symptoms of constipation in acute ischemic stroke patients.The status of bowel movements in acute ischemic stroke can reflect the severity of neurological impairment and predict neurological outcomes at 1 month.
