重症康复病房患者气管切开状态下呼吸训练效果观察

关键词：气管切开  重症康复  呼吸训练

Keywords:tracheotomy  intensive rehabilitation  respiratory training

摘要：

      摘要 目的：探讨重症康复病房患者气管切开状态进行呼吸训练的应用效果。 方法：选取在某两家医院重症康复病房住院的气管切开患者115例，采取抛硬币方法随机分为对照组56例、干预组59例，对照组采取常规气管切开康复护理措施，干预组在对照组的基础上增加呼吸训练方法，包括堵管训练、缩唇呼吸、呼吸控制、呼吸训练器训练及咳嗽训练5项。通过呼吸训练器记录两组患者康复训练前后的用力肺活量（forced vital capacity，FVC）及深吸气量（inspiratory capacity，IC），统计两组患者成功拔管例数；观察两组患者堵管期间肺部感染发生状况。 结果：干预组经过呼吸训练，较对照组拔管例数增加、肺部感染例数减少，干预组康复训练后FVC及IC值较对照组高，差异有显著性意义。 结论：对重症康复病房气管切开患者在常规人工气道康复护理措施基础上进行呼吸训练能改善促进患者肺康复，加快患者拔除气管套管、降低肺部感染发生率。

Abstract:

      Abstract Objective： To investigate the efficacy of respiratory training on patients with tracheotomy in intensive rehabilitation and care unit (IRCU). Method： One hundred and fifteen patients with tracheotomy were recruited from two hospital IRCU， and then randomly divided into control group (n=56) to receive daily nursing and trial group (n=59) to receive， besides daily nursing， respiratory training which included plugging， labial breathing， breathing controlling， respiratory exerciser and cough training. The forced vital capacity (FVC)， inspiratory capacity (IC)， successfully cannula withdrawing and pneumonia rate were assessed to make a comparison between groups. Result： The successfully cannula withdrawing and pneumonia rate in trial group were significantly higher and less than those in control group respectively. FVC and IC in trial group were more than those in control group. Conclusions： The respiratory training is worthy of promoting in the pulmonary function in IRCU patients with tracheotomy.