呼吸道清除系统预防老年腹部手术后肺部感染的效果

目的比较呼吸道清除系统（VestTM系统）排痰法与传统人工叩击排痰法预防老年腹部手术后肺部感染的效果。方法将60例老年腹部手术患者随机分为观察组（n=30）和对照组（n=30），观察组使用VestTM系统排痰法，对照组采用传统人工叩击排痰。比较两组治疗效果。结果观察组患者第1天排痰量为（25．32±2．12）ml／d，高于对照组第1天排痰量（14．20±1．58）ml／d，差异有统计学意义（t=23．04，P〈0．05），第2，3，4天两组患者排痰量比较差异均有统计学意义（P〈0．05）；观察组刀口疼痛例数为6例，VAS评分为（4．2±0．2）分，体位配合困难例数为3例，对照组分别为为21例，（7．2±0．3）分，16例，两组以上三项比较差异均有统计学意义（x2=13．20，11．09，t=45．57，P〈0．05）；在血流动力学、引流液的量方面比较差异无统计学意义（P〉0．05）。结论VestTM系统的排痰效果和患者的接受程度优于传统人工叩击排痰法，可有效预防老年腹部手术后肺部感染的发生。

Effect of airway clearance system on pulmonary infection prevention in elderly patients undergone abdominal operation

Objective To compare the effect of airway clearance system (VestTM system) and traditional person knocking method on expectoration and pulmonary infection prevention in elderly patients undergone abdominal operation. Methods 60 cases of elderly patients undergone abdominal operation were randomly divided into observation group (n = 30) and control group (n = 30). The control group received person knocking method to promote expectoration while the observation group was treated with VestTM system.Clinical effect was compared between the groups. Results Sputum volume on day 1 of the observation group [(25.32 ± 2.12) ml/d] was higher than that of the control group [(14.20 ± 1.58) ml/d], and the difference was statistically significant (t = 23.04, P ＜ 0.05). There were also significant differences of sputum volume on day 2, day 3 and day4 (P＜0.05). 6 cases of cut pain, (4.2±0.2) scores of VAS and3 cases of difficulty in position cooperation were reported in the observation group, while the control group reported 21 cases,(7.2±0.3) scores and 16 cases, respectively, the differences were statistically significant (x2 = 13.20,11.09, respectively, t = 45. 57, P ＜ 0.05). There was no significant difference regarding hemodynamics and drainage volume (P ＞ 0.05). Conclusions Compared with traditional person knocking method, the VestTM system has satisfying effect of expectoration and popularity with patients, and can effectively prevent pulmonary infection in elderly patients undergone abdominal operation.