摘要
目的探讨急性呼吸衰竭机械通气患者进行吸气肌力量训练对脱机效果的影响。方法选取河南科技大学第一附属医院2021-03-12-2022-11-12收治的115例急性呼吸衰竭机械通气患者为研究对象,随机分为对照组(n=57)和观察组(n=58)。对照组给予常规处理,观察组联合吸气肌力量训练。于干预前和干预2周后,采用呼吸机自带的肺功能检测装置,检测并对比2组患者吸气流速峰值(PIF)、最大吸气压(MIP)、吸气容积(Volume)、能量(Energy)水平,以及2组患者第1秒用力呼气容积/用力肺活量(FEV1/FVC)、用力肺活量(FVC)、第1秒用力呼气容积占预计值百分比(FEV1%)水平;记录2组患者ICU住院时间、脱机成功率;记录并对比2组患者ICU获得性衰弱(ICU-AW)发病率。结果观察组干预后,PIF水平为(5.35±0.60)L/s,高于对照组的(4.80±0.55)L/s,差异有统计学意义,F=5.122,P<0.001;MIP水平为(74.45±4.20)cmH_(2)O,高于对照组的(65.66±3.52)cmH_(2)O,差异有统计学意义,F=12.153,P<0.001;Volume水平为(2.38±0.44)L,高于对照组的(2.38±0.44)L,差异有统计学意义,F=3.062,P<0.001;Energy水平为(35.85±3.10)J,高于对照组的(32.51±2.44)J,差异有统计学意义,F=6.413,P<0.001;FEV1%水平为(74.52±2.76)%,高于对照组的(71.26±2.97)%,差异有统计学意义,F=6.099,P<0.001;FVC水平为(2.33±0.36)L,高于对照组的(1.94±0.45)L,差异有统计学意义,F=5.137,P<0.001;FEV1/FVC水平为74.34±2.95,高于对照组的70.57±2.86,差异有统计学意义,F=6.956,P<0.001。观察组ICU住院时间为(16.80±1.26)d,低于对照组的(18.29±1.33)d,差异有统计学意义,t=6.168,P<0.001;脱机成功率为89.66%,高于对照组的63.16%,差异有统计学意义,χ^(2)=11.235,P=0.001;ICU-AW发病率为25.86%,低于对照组的45.61%,差异有统计学意义,χ^(2)=4.889,P=0.027。结论吸气肌力量训练能够有效提高急性呼吸衰竭机械通气患者吸气肌功能,促进肺功能恢复,提高脱机成功率,降低ICU-AW发病率,缩短�
Objective To study the improvement effect of inspiratory muscle strength training on weaning from mechanical ventilation in patients with acute respiratory failure.Methods A total of 115 patients with mechanical ventilation of acute respiratory failure were randomly assigned to the First Affiliated Hospital of Henan University of Science and Technology from March 12,2021 to November 12,2022.Totally 57 patients in the control group received routine treatment,and 58 patients in the observation group received combined inspiratory muscle strength training.Before and 2 weeks after the intervention,the lung function testing device included in the ventilator was used to detect and compare the peak inspiratory flow rate(PIF),maximum inspiratory pressure(MIP),inspiratory volume(Volume),and energy levels of two groups of patients,as well as the first second forced expiratory volume/forced vital capacity(FEV1/FVC),forced vital capacity(FVC),and the percentage of first second forced expiratory volume to expected value(FEV1%)of the two groups of patients.ICU stay time and mechanical ventilation weaning rate of the two groups were recorded.The incidence of ICU acquired asthenia(ICU-AW)was recorded and compared between the two groups.Results After intervention,the level of PIF in observation group(5.35±0.60)L/s was higher than that in control group(4.80±0.55)L/s,and the difference was statistically significant(F=5.122,P<0.001).After intervention,the MIP level of observation group(74.45±4.20)cmH_(2)O was higher than that of control group(65.66±3.52)cmH_(2)O,the difference was statistically significant(F=12.153,P<0.001).After intervention,the Volume level in the observation group was(2.38±0.44)L higher than that in the control group(2.38±0.44)L,and the difference was statistically significant(F=3.062,P<0.001).After intervention,energy level of observation group(35.85±3.10)J was higher than that of control group(32.51±2.44)J,and the difference was statistically significant(F=6.413,P<0.001).After intervention,the FEV1%level
作者
黄娟
王岚
杨冬梅
孙丹影
HUANG Juan;WANG Lan;YANG Dongmei;SUN Danying(Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)
出处
《社区医学杂志》
CAS
2023年第24期1305-1309,共5页
Journal Of Community Medicine
基金
2022年度医疗卫生指导下科技计划项目(2022056Y)。
关键词
急性呼吸衰竭
吸气肌
肺功能
机械通气
acute respiratory failure
inspiratory muscle
lung function
mechanical ventilation
