| 杨宁,李晓兵,侯丽敏,祝豫,吕靖,李彤,张续恒,许长锋,司新艳,杜振峰.徒手咳嗽辅助技术联合主动呼吸循环技术对脑卒中后肺部感染患者肺功能的影响[J].中国康复,2023,38(9):529-533 |
| 徒手咳嗽辅助技术联合主动呼吸循环技术对脑卒中后肺部感染患者肺功能的影响 |
| Effects of manual cough assist techniques combined with active cycle of breathing techniques on pulmonary function of patients with pulmonary infection after stroke |
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| DOI： |
| 中文关键词: 主动呼吸循坏技术 徒手咳嗽辅助技术 脑卒中 肺部感染 肺功能 |
| 英文关键词: active cycle of breathing techniques manual cough assist techniques stroke pulmonary infection pulmonary function |
| 基金项目:河南省医学科技攻关计划联合共建项目（LHGJ20200692）;河南省中医药科学研究专项课题项目（20-21ZY2281） |
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| 中文摘要: |
| 目的：探究徒手咳嗽辅助技术联合主动呼吸循环技术对脑卒中后肺部感染患者肺功能的影响。方法：选取脑卒中后肺部感染患者120例，随机分为对照组和观察组，每组60例。2组均给予抗感染及常规呼吸训练，在此基础上，对照组给予机械排痰仪联合主动呼吸循环技术治疗，观察组给予徒手咳嗽辅助技术联合主动呼吸循环技术治疗，连续治疗4周。分别于治疗前、治疗后记录患者日均排痰量、日有效咳嗽次数，采用智能便携式肺功能检测仪评定患者用力肺活量（FVC）、第一秒用力呼气量（FEV1）、每分钟最大通气量（MVV）、峰值呼气流速（PEF），酶联免疫吸附试验检测患者C-反应蛋白（CRP）、降钙素原（PCT）水平，改良英国医学研究委员会呼吸困难量表（mMRC）评定呼吸困难程度，圣乔治呼吸问卷（SGRQ）评分评定生活质量。结果：与治疗前相比，2组患者治疗后日均排痰量、日有效咳嗽次数均明显下降（P<0.05），且观察组低于对照组（P<0.05）；与治疗前相比，2组患者治疗后FVC、FEV1、MVV及PEF水平均显著提升（P<0.05），且观察组的FVC、FEV1、MVV及PEF水平明显高于对照组（P<0.05）；与治疗前相比，2组患者治疗后CRP、PCT水平、mMRC及SGRQ评分均显著降低（P<0.05），且观察组的CRP、PCT水平、mMRC及SGRQ评分明显低于对照组（P<0.05）。结论：徒手咳嗽辅助技术联合主动呼吸循环技术治疗脑卒中后肺部感染有助于促进患者痰液排出，减弱患者机体炎症反应，提高患者肺功能，改善患者呼吸困难和生活质量。 |
| 英文摘要: |
| Objective: To investigate the effect of manual cough assist techniques combined with active cycle of breathing techniques on pulmonary function of patients with pulmonary infection after stroke. Methods: A total of 120 patients with pulmonary infection after stroke were randomly divided into control group and observation group, 60 cases in each group. The patients in two groups were given anti-infective therapy and conventional respiration training. Additionally, the control group was given a mechanical sputum expeller combined with active cycle of breathing techniques training, and the observation group was given manual cough assist techniques combined with active cycle of breathing techniques training. The treatment was continued for 4 weeks. The average daily sputum output and the effective number of daily coughs were recorded before and after treatment. The forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), maximum ventilation per minute (MVV) and peak expiratory flow (PEF) were evaluated by intelligent portable over device pulmonary function tester. The levels of C-reactive protein (CRP) and procalcitonin (PCT) were tested by enzyme linked immunosorbent assay. The dyspnea was evaluated by the modified British Medical Research Council Dyspnea Scale (mMRC), and the quality of life was evaluated by the St. George’s Respiratory Questionnaire (SGRQ). Results: Compared to before treatment, the average daily sputum output and the effective number of daily coughs were significantly improved in both groups after treatment, and these in the observation group was better than in the control group (P<0.05). Compared to before treatment, the levels of FVC, FEV1, MVV and PEF were significantly higher in both groups after treatment, and the levels of FVC, FEV1, MVV and PEF in the observation group were significantly higher than those in the control group (P<0.05). Compared to before treatment, the levels of CRP, PCT, mMRC and SGRQ scores were significantly lower in both groups and the levels of CRP, PCT, mMRC and SGRQ scores in the observation group were significantly lower than those in the control group (P<0.05). Conclusion: The manual cough assist techniques combined with active cycle of breathing techniques training in the treatment of patients with pulmonary infection after stroke helps to promote sputum expulsion, attenuate the inflammatory response of the patient’s organism, improve the patient’s pulmonary function, and improve the patient’s dyspnoea and quality of life. |
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