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为了探讨综合胸部物理治疗的对呼吸机相关性肺炎的预防作用,本研究选取2014年1月~2016年12月前来我院进行使用呼吸机的253例入选患者作为研究对象,随机分为2组,试验组128例,对照组125例,试验组由2名经过培训的护士进行综合胸部物理治疗,对照组仅给予ICU常规胸部物理治疗。通过比较气管插管机械通气病人综合胸部物理治疗与重症监护室(intensive care unit,ICU)常规胸部物理治疗的呼吸机相关性肺炎(ventilator associated pneumonia,VAP)的发生率,发现两组患者在性别、年龄、感染与否、急性生理及慢性健康评分系统Ⅱ(APACHEⅡ)、急性生理评分比较中,差异均无统计学意义(p>0.05),两种胸部物理治疗方式在ICU入住时间、机械通气时间、住院时间比较中,差异无统计学意义(p>0.05);综合物理治疗组VAP发生率为26.56%(35例),ICU常规胸部物理治疗组VAP发生率为47.20%(59例)。本研究进一步证实,与ICU常规胸部物理治疗相比,综合胸部物理治疗可促进痰液排出,从而使机械通气患者的VAP的发生率降低。我们的研究为综合胸部物理治疗在呼吸机相关性肺炎预防中的应用提供了一定的理论依据。
Abstract：In order to discuss the chest physical therapy on the prevention of ventilator associated pneumonia, this research selected 253 patients who were treated in our hospital from January 2014 to December 2016 and randomly divided them into two groups, containing the treatment group of 128 examples and the control group of125 cases. The treatment group was conducted by two trained nurses with comprehensive chest physical therapy and the control group was only given routine chest physical therapy in the ICU. By comparing the incidence of ventilator associated pneumonia(VAP) in comprehensive chest physical therapy and routine chest physical therapy of intensive care unit(ICU), we found that there was no statistically significant difference in gender, age, infection,acute physiology and chronic health evaluation system Ⅱ(APACHEⅡ), acute physiology score comparison of patients in two groups(p>0.05); in the ICU stay time, mechanical ventilation time, hospitalization time, two types of chest physical therapy had no statistically significant difference(p >0.05); the VAP incidence of comprehensive chestphysical therapy group was 26.56%(35 cases), and the VAP incidence of ICU routine chest physical therapy group was 47.20%(59 cases). These results further verified that compared with routine chest physical therapy in ICU, comprehensive chestphysical therapy could promote sputum discharge, thus reduce the incidence of VAP in patients with mechanical ventilation. Our research would provide some theoretical basis for application of comprehensive chestphysical therapy in the prevention of ventilator associated pneumonia.
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基本信息:
DOI：10.13417/j.gab.037.000142
中图分类号:R563.1
引用信息:
[1]魏志明,夏立平.综合胸部物理治疗可预防呼吸机相关性肺炎[J].基因组学与应用生物学,2018,37(01):142-148.DOI:10.13417/j.gab.037.000142.
基金信息:
2016盐城市医学科技发展计划项目(YK2016058)资助
2018-01-25
2018-01-25