摘要
目的:探究高频胸壁振荡排痰仪(HFCWO)排痰时机对电视胸腔镜肺叶切除术(VATS)高龄肺癌患者肺部并发症及肺功能康复的影响。方法:选取80例拟行VATS手术的高龄肺癌患者,将其分为HFCWO排痰组(HFCWO组)与常规胸部叩背排痰组(CCT组),每组40例;HFCWO组患者根据使用时机进一步分为早期HFCWO组和滞后HFCWO组;比较各组患者排痰的效果、舒适度、耐受度及护士操作的强度以及循环指数及肺功能指标的变化。结果:HFCWO组的24 h平均排痰量多于CCT组,且早期HFCWO组多于滞后组(P<0.05);胸管置管时间、术后住院时间短于对照组(P<0.05),肺部并发症发生率低于对照组(P<0.05),但早期HFCWO组与滞后HFCWO组之间比较其差异无统计学意义(P>0.05);3组之间心率(HR)、呼吸频率(RR)、收缩压(SBP)和舒张压(DBP)值经比较其差异也均无统计学意义(P>0.05);治疗后,HFCWO组患者脉搏血氧饱和度(SpO2)、动脉血氧分压(PaO2)均高于CCT组,动脉二氧化碳分压(PaCO2)均低于CCT组(P<0.05);早期与滞后HFCWO组经比较其差异均无统计学意义(P>0.05);术后7 d、14 d,HFCWO组的每分钟最大通气量(MVV)、第1秒用力呼气容积(FEV1)和用力肺活量(FVC)均高于CCT组,且早期HFCWO组高于滞后HFCWO组(P<0.05);HFCWO组患者舒适度、耐受性及护理人员操作强度均优于CCT组(P<0.05),但早期与滞后HFCWO组经比较其差异无统计学意义(P>0.05)。结论:HFCWO用于高龄患者VATS术后的体疗对生命体征干扰小,可有效降低肺部并发症发生率并促进了肺功能康复,且早期HFCWO的改善效果更佳。
Objective:To explore the influence of high-frequency chest wall oscillation (HFCWO) on postoperative pulmonary complications and pulmonary function in senior patients with video-assisted thoracoscopic surgery(VATS).Methods:80 senior patients who underwent VATS were randomly divided into HFCWO group and conventional chest percussion phlegm therapy group (CCT group),with 40 cases in each group.HFCWO group was further divided into early HFCWO group and delayed HFCWO group based on the timing of HFCWO.The sputum excretion effect,patient comfort,tolerance and nurse operation intensity of each group were compared,and the changes of circulatory and lung function indexes were observed.Results:The average 24-hour sputum output of the HFCWO group was higher than that of the CCT group,the early HFCWO group was higher than the delayed group (P<0.05),the chest tube placement time,postoperative hospital stay,and the incidence of pulmonary complications of HFCWO group were lower than those of the control group (P<0.05),but there was no significant difference between the early and delayed HFCWO group (P>0.05).There were no significant differences in heart rate (HR),respiratory rate (RR),systolic blood pressure (SBP),and diastolic blood pressure (DBP) among the three groups (P>0.05).After treatment,thethe HFCWO group were higher than those of the CCT group,and thelower than that of the CCT group (P<0.05),but there was no significant difference between the early and delayed HFCWO group (P>0.05).At 7days and 14 days after surgery,the maximal ventilatory volume (MVV),forced expiratory volume in 1 secondand forced vital capacity (FVC) in the HFCWO group were higher than those in the CCT group,and the early HFCWO group was higher than the delayed HFCWO group (P<0.05).The comfort,tolerability of patients and operation intensity of nurse in HFCWO group were better than those of CCT group (P<0.05),but there was no significant difference between early and delayed HFCWO group (P>0.05).Conclusion:HFCWO with minimal influences on vital signs
作者
朱雪娟
王一飞
段善州
杨文涛
桑永华
陈勇兵
ZHU Xue-juan;WANG Yi-fei;Duan Shan-zhou;YANG Wen-tao;SANG Yong-hua;CHEN Yong-bing(Department of Thoracic Surgery,The No.2 Hospital Affiliated to Suzhou University,Suzhou Jiangsu 215004,China)
出处
《抗感染药学》
2020年第9期1346-1351,共6页
Anti-infection Pharmacy
基金
苏州市护理学会护理科研重点学科项目(编号:SZXK201803)
苏州市胸部肿瘤重点实验室项目(编号:SZS201907)
苏州市科技发展(民生科技)项目(编号:SS2019061)。
