摘要
目的探讨咳嗽辅助仪(Cough Assist)用于清理神经肌肉疾病合并呼吸功能不全患者气道内分泌物的临床疗效。方法对46例神经肌肉疾病合并呼吸功能不全患者(气管插管机械通气患者34例、气管切开患者12例,其中吉兰-巴雷综合征患者24例、重症肌无力18例、多发性肌炎患者4例),采用随机数字表法随机分为A组(23例)和B组(23例)。其中A组患者使用咳嗽辅助仪清理呼吸道分泌物,B组患者使用机械振动排痰后采用吸痰管清理呼吸道分泌物。清理气道分泌物后,记录两组患者24 h内吸痰次数、患者氧合指数、肺静态顺应性及肺部感染率,同时记录吸痰后肺部听诊情况及胸部X线片显示结果。结果研究显示,咳嗽辅助仪能更充分清理患者呼吸道分泌物,明显改善患者的氧合指标、肺部听诊及肺部感染率,同时能减轻护理工作量。结论使用咳嗽辅助仪能有效清理神经肌肉疾病合并呼吸功能不全患者气道内分泌物,改善氧合,同时能减少肺部感染率及护理工作量,值得在临床推广。
Objective To investigate the clinical efficacy of Cough Assist for cleaning airway secretions in neuromuscular disease patients with respiratory insufficiency. Methods Forty-six cases of neuromuscular disease with respiratory insufficiency were recruited in the study,with Guillain-Barre syndrome in 24 cases,myasthenia gravis in 18 cases,and multiple myositis in 4 patients. Thirty-four patients underwent intubation and mechanical ventilation,and 12 patients underwent tracheotomy. They were randomly divided into group A using Cough Assist and group B using suction tube to clear airway secretions after mechanical vibration. The frequency of suction within 24 hours,oxygenation index,pulmonary static compliance,incidence of lung infections,lung auscultation and chest radiograph were recorded and compared between two groups. Results Cough Assist could more effectively clean respiratory secretions with higher oxygenation index and pulmonary static compliance in group A. Lung auscultation and chest radiograph significantly improved,and the incidence of lung infection significantly decreased in group A compared with group B.Furthermore,Cough Assist reduced nursing workload with lower frequency of suction within 24 hours.Conclusions Cough Assist can effectively clean up airway secretions,improve oxygenation,while reducing pulmonary infection and nursing workload for neuromuscular disease patients with respiratory insufficiency,so it is aworthy tool in clincal practice.
出处
《中国呼吸与危重监护杂志》
CAS
2014年第6期588-590,共3页
Chinese Journal of Respiratory and Critical Care Medicine
