摘要
目的观察气道廓清术联合高流量湿化氧疗在卒中相关性肺炎患者气管切开术后康复治疗中的应用效果。方法将50例气管切开术后的卒中相关性肺炎患者随机分为观察组和对照组,每组25例。两组均给予脑卒中及肺炎标准药物治疗及常规护理;对照组给予高流量湿化氧疗,观察组在对照组基础上给予气道廓清术。比较两组临床疗效、临床症状评分、炎症指标[白细胞计数、中性粒细胞百分比、C反应蛋白(CRP)、降钙素原(PCT)]、膈肌运动度、膈肌厚度及拔管成功率。结果观察组治疗总有效率及拔管成功率高于对照组(P均<0.05)。两组治疗后咳嗽、咳痰、发热症状评分及白细胞计数、中性粒细胞百分比、CRP、PCT均较治疗前降低,且观察组治疗后低于对照组(P均<0.05)。观察组治疗后膈肌运动度及膈肌厚度高于治疗前及治疗后对照组(P均<0.05)。结论气道廓清术联合高流量湿化氧疗用于行气管切开术的卒中相关性肺炎患者效果较好,能够更有效地减轻咳嗽、咳痰等症状,降低炎症水平,改善膈肌运动功能和肺功能,提高拔管成功率。
Objective To observe the application effect of airway clearance technique combined with high-flow hu midified oxygen therapy in the rehabilitation treatment of patients with stroke-associated pneumonia after tracheotomy.Methods Fifty patients with stroke-associated pneumonia after tracheotomy were randomly divided into the observation group and control group,with 25 cases in each group.Patients in both groups were given standard drug treatment for stroke and pneumonia and routine care;the control group was given high-flow humidified oxygen therapy,while the observation group was given airway clearance on the basis of the treatment of the control group.The clinical efficacy,clinical symptom scores,inflammatory indicators[white blood cell count,neutrophil percentage,C-reactive protein(CRP),procalcitonin(PCT)],diaphragm mobility,diaphragm thickness and extubation success rate were compared between the two groups.Results The total effective rate and extubation success rate in the observation group were significantly higher than those in the control group(both P<0.05).Both groups exhibited significant reductions in cough,expectoration,and fever symptom scores,as well as white blood cell count,neutrophil percentage,CRP,and PCT levels after treatment as compared with those before treatment.Furthermore,these post-treatment parameters in the observation group were significantly lower than those in the control group(all P<0.05).Additionally,diaphragmatic mobility and diaphragm thickness in the observation group demonstrated significant improvement as compared with both pretreatment values and post-treatment levels in the con trol group(all P<0.05).Conclusions The combination of airway clearance and high-flow humidified oxygen therapy demonstrated favorable clinical outcomes in stroke-associated pneumonia patients undergoing tracheostomy.This therapeu tic approach was more effective in alleviating clinical symptoms such as cough and sputum production,reducing inflammato ry levels,improving diaphragmatic function and pulmonary performance,and enhancing the success rate of decannulation.
作者
王静静
杨牧
王风云
WANG Jingjing;YANG Mu;WANG Fengyun(Rehabilitation Department,Liaocheng People's Hospital Brain Hospital,Liaocheng 252000,China)
出处
《山东医药》
2025年第2期101-105,共5页
Shandong Medical Journal
基金
山东省中医药科技项目(Z-2022040)。
关键词
气道廓清术
高流量湿化氧疗
卒中相关性肺炎
气管切开术
airway clearance
high-flow humidified oxygen therapy
stroke-associated pneumonia
tracheotomy
