背景:这项研究的目的是评估早期分级肺康复训练计划对因脑干出血而接受机械通气的患者的影响。
方法:选取2022年8月至2023年10月在我院神经外科因脑干出血而接受机械通气的80例患者作为研究对象。根据入院顺序生成抽样表,使用SPSS软件生成80个随机序列。然后按升序对这些序列进行排序,前半部分为对照组,后半部分为干预组,每个包括40例。对照组给予脑干出血患者机械通气的标准护理,而干预组在标准护理的基础上进行早期分级肺康复训练。这项干预是与多学科呼吸重症监护康复小组合作进行的。这项研究比较了呼吸功能指标,呼吸机断奶成功率,呼吸机相关性肺炎发病率,机械通气持续时间,两组之间的患者出院时间。
结果:观察组与对照组在第1、3、5、7天的呼气峰值流量和最大吸气压力比较,差异有统计学意义(P<0.05)。此外,干预的主要效应和时间的主要效应之间有统计学意义的交互作用(P<0.05)。观察组撤机成功率(62.5%)明显高于对照组(32.5%),差异有统计学意义(P<0.05)。此外,观察组呼吸机相关性肺炎发生率(2.5%)明显低于对照组(17.5%)(P<0.05)。此外,观察组的机械通气时间和住院时间均明显短于对照组(P<0.05)。
结论:早期分级肺康复训练显示出增强呼吸功能的有效性,提高呼吸机退出成功率,并减少机械通气患者脑干出血的机械通气时间和住院时间。这些发现表明了在临床实践中推广这种干预措施的潜在价值。
BACKGROUND: The objective of this study is to assess the impact of an early-graded pulmonary rehabilitation training program on patients undergoing mechanical ventilation due to brainstem hemorrhage.
METHODS: Eighty patients receiving mechanical ventilation due to brainstem hemorrhage at our hospital\'s neurosurgery department between August 2022 and October 2023 were enrolled as participants. A sampling table was generated based on the order of admission, and 80 random sequences were generated using SPSS software. These sequences were then sorted in ascending order, with the first half designated as the control group and the second half as the intervention group, each comprising 40 cases. The control group received standard nursing care for mechanical ventilation in brainstem hemorrhage cases, while the intervention group underwent early-graded pulmonary rehabilitation training in addition to standard care. This intervention was conducted in collaboration with a multidisciplinary respiratory critical care rehabilitation team. The study compared respiratory function indices, ventilator weaning success rates, ventilator-associated pneumonia incidence, mechanical ventilation duration, and patient discharge duration between the 2 groups.
RESULTS: The comparison between patients in the observation group and the control group regarding peak expiratory flow and maximum inspiratory pressure on days 1, 3, 5, and 7 revealed statistically significant differences (P < .05). Additionally, there was a statistically significant interaction between the main effect of intervention and the main effect of time (P < .05). The success rate of ventilator withdrawal was notably higher in the observation group (62.5%) compared to the control group (32.5%), with a statistically significant difference (P < .05). Moreover, the incidence rate of ventilator-associated pneumonia was significantly lower in the observation group (2.5%) compared to the control group (17.5%) (P < .05). Furthermore, both the duration of mechanical ventilation and hospitalization were significantly shorter in the observation group compared to the control group (P < .05).
CONCLUSIONS: Early-graded pulmonary rehabilitation training demonstrates effectiveness in enhancing respiratory function, augmenting the ventilator withdrawal success rate, and reducing both the duration of mechanical ventilation and hospitalization in mechanically ventilated patients with brainstem hemorrhage. These findings suggest the potential value of promoting the application of this intervention in clinical practice.