河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (5): 526-530.doi: 10.3969/j.issn.1007-3205.2023.05.006

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人工膨肺治疗对脑卒中气管切开患者生存质量的影响

  

  1. 1.山西省临汾市中心医院康复医学科， 山西 临汾 041000；2.山西医科大学第一医院康复医学科，山西 太原  030000

  • 出版日期:2023-05-25 发布日期:2023-05-25
  • 作者简介:朱瑜（1987-），女，山东莱州人，山西省临汾市中心医院主治医师，医学博士研究生，从事运动康复研究。
  • 基金资助:
    山西省卫生健康委科研项目（2020160）

Effect of manual hyperinflation on quality of life in stroke patients undergoing tracheotomy

  1. 1.Department of Rehabilitation Medicine, Linfen Central Hospital, Shanxi Province, Linfen 
    041000, China； 2.Department of Rehabilitation Medicine, the First Hospital of 
    Shanxi Medical University, Taiyuan 030000, China

  • Online:2023-05-25 Published:2023-05-25

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摘要： 目的 分析人工膨肺治疗对脑卒中气管切开患者生存质量的影响。
方法 采用随机数字表法选取于山西省临汾市中心医院康复医学科收治的100例脑卒中气管切开患者分为2组，对照组（50例）采用常规气管切开气道管理，试验组（50例）在对照组基础上实施人工膨肺，对比2组的干预前后总住院时间、加强监护病房综合治疗室（intensive care unit，ICU）住院时间与拔管时间、肺功能、生活质量、日常生活活动能力、运动功能、吞咽功能分级及并发症发生情况。
结果 干预后，2组的用力肺活量占预计值百分比（first virtual communications，FVC）、一秒用力呼气容积（forced expiratory volume in one second，FEV1）水平明显升高，且试验组高于对照组（P＜0.05）。2组的生理、心理、独立性、社会关系、环境及精神方面评分明显升高，且试验组高于对照组（P＜0.05）。2组的Barthel指数（Barthel index，BI）及Fug1-Meyer运动功能积分（ Fugl-Meyer assessment scale，FMA）明显升高，且试验组高于对照组（P＜0.05）。2组的吞咽功能分级明显改善，且试验组优于对照组（P＜0.05）。试验组的并发症总发生率低于对照组（P＜0.05）。试验组的总住院时间、ICU住院时间与拔管时间明显少于对照组（P＜0.05）。
结论 人工膨肺可有效提高脑卒中气管切开患者的肺功能，并明显改善运动功能、吞咽功能，提高生存质量，减少并发症的发生，促进患者早日康复，值得在临床推广应用。


关键词: 卒中, 气管切开术, 生活质量

Abstract: Objective To analyze the effect of manual hyperinflation(MHI) on the quality of life of stroke patients undergoing tracheotomy. 
Methods A total of 100 stroke patients undergoing tracheotomy after admission to the Department of Rehabilitation Medicine of Linfen Central Hospital, Shanxi Province were selected and divided into two groups. The control group (n=50) received conventional tracheotomy airway management, and the experimental group (n=50) received MHI on the basis of the control group. The total length of hospital stay before and after the intervention, the length of intensive care unit (ICU) stay, time to extubation, lung function, quality of life, activities of daily living (ADL), motor function, swallowing function classification and the incidence of complications were compared between two groups. 
Results After intervention, forced vital capacity (FVC%) and forced expiratory volume in one second (FEV1%) in both groups were significantly increased, which were higher in the experimental group than in the control group (P＜0.05). The scores of physiology, psychology, independence, social relationship, environment and spirit of the two groups were significantly increased, which were higher in the experimental group than in the control group (P＜0.05). Barthel index (BI) and Fug1-Meyer motorassessment (FMA) score in both groups were significantly increased, which were higher in the experimental group than in the control group (P＜0.05). The classification of swallowing function in the two groups was significantly improved, which were better in the experimental group than in the control group (P＜0.05). The total incidence of complications in experimental group (10.00%) was significantly lower than that in control group (P＜0.05). The total length of hospital stay, length of ICU stay and time to extubation in the experimental group were significantly shorter than those in control group (P＜0.05). 
Conclusion MHI can effectively improve the lung function of stroke patients undergoing tracheotomy, and significantly improve the motor function, swallowing function and the quality of life, reduce the incidence of complications, and promote the early recovery of patients. Therefore, it is worthy of clinical application. 


Key words: stroke, tracheotomy, quality of life

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