高频胸壁振荡在腹部术后老年患者中的应用

目的探讨高频胸壁振荡在腹部术后老年患者中的应用方法及效果。方法便利抽样法选择2014年1月至2015年9月在上海复旦大学附属华东医院行腹部手术后进入重症监护病房治疗的80例老年患者为研究对象,按手术先后将其分为对照组和观察组各40例,对照组患者给予常规的治疗与护理措施,观察组在对照组的基础上进行高频胸壁振荡(high frequency chest wall oscillation,HFCWO)治疗,评价并比较两组患者干预前后的呼吸相关指标、疼痛程度、实际可耐受人工叩背或高频胸部振荡的持续时间及护理人员每天操作所用时间。结果干预前,两组患者的动脉氧分压(PaO_2)、动脉血氧饱和度(SaO_2)、动脉二氧化碳分压(PaCO_2)、氧合指数(OI)的差异均无统计学意义(均P0.05);术后第3天,观察组患者的PaO_2、SaO_2及OI均优于对照组(均P0.05);术后第5天,观察组患者的SaO_2优于对照组(P0.05);术后2~5d,观察组患者的疼痛程度均明显低于对照组(均P0.05);术后1~5d与对照组比较,观察组患者的实际可耐受人工叩背或高频胸部振荡的持续的时间均长于对照组患者,护理人员每天操作所用时间均短于对照组患者,差异均有统计学意义(均P0.05)。结论与常规胸部物理治疗方法相比,HFCWO治疗可短期改善老年腹部手术患者术后的呼吸功能,降低患者的疼痛程度,延长患者的耐受时间,缩短护理人员实际操作时间,提高护理人员的工作效率。

Application of High Frequency Chest Wall Oscillation on Elderly Patients Underwent Abdominal Surgery

(HFCWO) in elderly patients underwent abdominal surgery.Methods By convenience sampling,80 cases were select-ed and divided into control group and observation group,with 40 cases in each group.The control group re-ceived routine care,while the observation group received HFCWO treatment on the basis of routine care. The respiration related indexes,pain level,tolerated percussion on back time,HFCWO duration time and actual nursing time before and after intervention were compared.Results Before intervention,there was no statistical significance of PaO 2 ,SaO 2 ,PaCO 2 and OI found between two groups (all P >0.05).Three days after surgery,the PaO 2 ,SaO 2 and OI in observation group were better than that of control group (all P <0.05).Five days after surgery,the SaO 2 in observation group were better than that of control group (P <0.05).Between day 2 to day 5,the pain level in observation group was significantly lower than that of con-trol group (all P <0.05).One to five days after surgery,the tolerated percussion on back time and HFC-WO duration time in the observation group were longer than that of control group,the actual nursing time was less than that of control group (all P <0.05).Conclusion Compared to conventional chest physiother-apy,HFCWO could improve the respiration function of elderly abdominal post-operative patients in a short-term,as well as release the pain,prolong the tolerance time,and shorten the nursing time.