G5振动排痰机对老年慢性阻塞性肺病患者排痰效果的分析

目的探讨G5振动排痰机对老年慢性阻塞性肺病患者排痰效果。方法84例老年慢性阻塞性肺病患者随机分为人工叩击排痰组40例和排痰机排痰组44例,比较两组患者排痰效果及动脉血气分析值。结果经过4d的排痰护理,两组患者排痰效果及动脉血气分析指标比较,差异存在统计学意义（均P〈0．05）,其中排痰机排痰组各项指标均优于人工叩击排痰组。结论应用G5振动排痰机对促进老年慢性阻塞性肺病患者排痰的效果优于人工叩击排痰法,值得临床推广应用。     

慢性阻塞性肺病体位与排痰护理

慢性阻塞性肺部疾病是由于慢性支气管炎、肺气肿反复发作 ,造成气体排出受阻 ,呈进行性加重的一组肺部疾病。其临床特点为慢性反复咳嗽、咳痰喘息 ,呼吸困难逐渐加重 ,严重的痰液阻塞 ,常可危及生命。为病人安排合理舒适的体位及采取有效的排痰方法是护理慢性阻塞性肺病的重要措施。现将护理体会介绍如下。1　临床资料本组 19例均为我院 1999年元月～ 2 0 0 0年 10月间的住院病人 ,其中男性 17例 ,女性 2例 ,年龄最大者 85岁 ,最小者 6 1岁 ,病程最长 32年 ,最短 3年。其中慢性支气管炎、肺气肿 13例 ,合并肺心病6例。全部病例均为急性发作…     

慢性阻塞性肺病体位与排痰的观察

通过对慢性阻塞性肺疾病（COPD）病人痰阻的原因与临床体征及体位与排痰措施的观察认为：针对COPD病人病情及个体差异采取及时有效的预防和护理对策，如高枕右侧卧位和前倾坐位交替使用，鼓励咯痰、湿化氧疗和雾化吸入等措施对清除呼吸道分泌物，保持气道通畅，提高氧疗及药物治疗的效果有着极为重要的作用。     

27例慢性阻塞性肺病体位与排痰的观察

慢性阻塞性肺疾病（ＣＯＰＤ）急性期常发生痰多及气道阻塞,并因低氧血症、高碳酸血症和酸碳失衡而危及患者生命。对ＣＯＰＤ病人痰阳的原因与临床体征以及体位与排痰措施的观察认为：针对ＤＯＰＤ病人病情及个体差异采取及时有效的预防和护理对策,如高枕右侧卧位和前倾坐位交替使用,鼓励咯痰、温湿化氧疗和雾化吸入等措施对清除呼吸道分泌物,保持气道通畅,提高氧疗及药物治疗的效果有着极为重要的作用。     

27例慢性阻塞性肺病体位与排痰的观察

慢性阻塞性肺疾病（ＣＯＰＤ） 急性期常发生痰多及气道阻塞,并因低氧血症、高碳酸血症和酸碱失衡而危及患者生命。对ＣＯＰＤ病人痰阻的原因与临床体征以及体位与排痰措施的观察认为：针对ＣＯＰＤ 病人病情及个体差异采取及时有效的预防和护理对策,如高枕右侧卧位和前倾坐位交替使用,鼓励咯痰、温湿化氧疗和雾化吸入等措施对清除呼吸道分泌物,保持气道通畅,提高氧疗及药物治疗的效果有着极为重要的作用。     

60例慢性阻塞性肺病病人的排痰护理

慢性阻塞性肺病是由于吸烟、感染、大气污染等有害因素刺激,引起终末细支气管远端的气道弹性减退,过度膨胀、充气和肺容积增大,并伴有气道壁的破坏,形成不可逆转的气道阻塞造成气体排出受阻,呈进行性加重的一组肺部疾病[1-3].近年在我国北中部地区农村患病率达3%,在世界居当前死亡原因的第四位.临床特点为慢性反复咳嗽、咳痰、喘息、呼吸困难逐渐加重,严重的痰液阻塞常可危及生命.因此对慢性阻塞性肺病病人采取积极有效的排痰护理措施很重要.本文对60例慢性阻塞性肺病病人排痰护理进行总结,结果如下.     

54例慢性阻塞性肺病体位排痰的临床护理

目的探讨通过体位排痰对慢性阻塞性肺病(COPD)患者在急性发作期痰多和气通阻塞的影响。方法选择54例COPD患者,利用前倾坐位、高枕右侧卧位和半卧位,结合呼吸道湿化、雾化等措施,鼓励并协助患者排痰。结果经过利用不同体位排痰后,多数患者恢复良好,大大降低了低氧血症,高碳酸血症和酸碱失调等并发症的发生。结论体位排痰对提高氧疗、药物效果和改善肺功能、预防并发症可起到重要的作用。     

振动排痰在重症肺炎排痰护理中的应用效果分析

目的探讨分析振动排痰在重症肺炎排痰护理中的临床应用效果。方法选取2017年1月～2018年7月间在我院进行治疗的重症肺炎患者120例,按照随机数字表达法将其随机分为对照组和观察组各60例。对照组患者给予人工叩击排痰护理,观察组患者给予振动排痰机进行振动排痰护理,每次排痰前、排痰后2h记录患者呼吸功能指标变化情况:氧合指数(PaO2/FiO2)、动脉血二氧化碳分压(PaCO2)、气道阻力(Raw),记录两组患者日平均排痰量,评估临床疗效。结果观察组日平均排痰量为49.7±11.8ml,显著多于对照组的37.5±9.5ml,差异有统计学意义(P0.05);排痰后观察组患者呼吸功能指标PaO2/FiO2、PaCO2、Raw改善效果显著优于对照组,差异均有统计学意义(P0.05);观察组临床治疗总有效率为93.3%,显著高于对照组的75.0%,差异有统计学意义(P0.05)。结论体外机械振动排痰能够有效清除重症肺炎患者呼吸道内痰液,排痰效果显著,可有效促进患者呼吸功能恢复,改善患者预后,值得临床推广应用。     

振动排痰机在神经外科危重患者中的应用

目的:探讨振动排痰机在神经外科危重患者中的应用效果。方法:将79例神经外科危重患者随机分为人工叩击排痰组(对照组)39例和振动排痰机组(试验组)40例进行辅助排痰,比较两组患者低氧血症、排痰量及肺部影像改变情况。结果:两组患者经过7 d治疗后,低氧血症、排痰量、肺部影像结果及肺部啰音均有所好转;试验组每日排痰量、低氧血症、肺部影像结果改善及肺部啰音消失比例明显优于对照组。结论:振动排痰机排痰效果优于单纯人工叩击排痰效果,可以在神经外科危重患者中作为一种常规的辅助排痰护理项目开展使用。     

慢性阻塞性肺病伴肺感染的排痰护理

慢性阻塞性肺疾病(COPD)是我国老年人的常见病，多发病。通常由慢性支气管炎发展而成，特点为气道阻塞和阻塞性呼吸功能障碍。当并发肺部感染时，老年人常因呼吸道黏膜纤毛运动减弱、肺功能低下、咳嗽无力及反应迟钝而使痰液阻塞气道，严重影响通气功能，使肺部感染经久不愈，甚至可以引起窒息而死亡。为了有效地清除呼吸道分泌物，我们在病人排痰     

探讨异丙托溴铵联合特布他林治疗老年慢性阻塞性肺疾病

目的：探讨异丙托溴铵和特布他林联合应用对老年慢性阻塞性肺疾病患者的临床疗效、调节性T细胞、肺功能改善进行分析性比较研究。方法将2010～2013年该院收治的100例老年慢性阻塞性肺疾病患者随机分为两组,特布他林组50例,联合组50例。治疗前后监测临床疗效、肺功能和血气分析变化。并采用酶联免疫吸附试验检测各组受试者血清细胞因子肿瘤坏死因子‐α（TNF‐α）、白细胞介素‐8（IL‐8）变化。结果94例完成试验,两组有效率分别是87．67％、66．76％,联合组优于对照组（P＜0．05）。治疗后,两组患者血氧分压,第1秒钟用力呼气容积、用力肺活量均较治疗前升高,二氧化碳分压较治疗前降低,组内比较差异均有统计学意义（P＜0．05）,且联合组优于特布他林组（P＜0．05）。血清细胞因子TNF‐α、IL‐8水平与治疗前相比,水平明显下降,组内治疗前后比较,差异有统计学意义（P＜0．05）。两组比较发现,联合组血清细胞因子TNF‐α、IL‐8水平明显下降,下降幅度大于特布他林组（P＜0．05）。结论异丙托溴铵和特布他林可以提高临床疗效,增强肺功能,改善血清细胞因子指标,治疗效果更优。     

Value of refined care in patients with acute exacerbation of chronic obstructive pulmonary disease

BACKGROUNDUnder physiological conditions, sputum produced during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can move passively with the cilia in the airway; the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway. However, when the sputum is thick, the cough is weak, or the tracheal cilia are abnormal, sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung. Furthermore, the presence of pathogenic microorganisms in sputum may cause or aggravate the symptoms of pulmonary infection in patients, which is the main factor leading to AECOPD. Therefore, promoting effective drainage of sputum and maintaining airway opening are key points requiring clinical attention.AIMTo explore the effect of refined nursing strategies in patients with AECOPD and dysphagia.METHODSWe selected 126 patients with AECOPD and difficulty of expectoration at our hospital, and divided them into a refined care group and a routine care group, with 63 cases each, using a random number table. The two groups of patients were treated with expectorant, anti-infection, oxygen inhalation, and other basic treatment measures; patients in the refined care group were given refined nursing intervention during hospitalization, and the routine care group received conventional nursing intervention. The differences in sputum expectoration, negative pressure suction rate, blood gas parameters, dyspnea score measured through the tool developed by the Medical Research Council (MRC), and quality of life were compared between the two groups. RESULTSAfter 7 d of intervention, the sputum expectoration effect of the refined care group was 62.30%, the effective rate was 31.15%, and the inefficiency rate was 6.56%. The sputum expectoration effect of the routine care group was 44.07%, the effective rate was 42.37%, and the inefficiency rate was 13.56%. The refined care group had better sputum expectoration than the routine care group (P < 0.05). The negative pressure suction rate in the refined care group was significantly lower than that of the routine care group during the treatment (22.95% vs 44.07%, P < 0.05). Before the intervention, the arterial oxygen saturation (PaO₂) and arterial carbon dioxide saturation (PaCO₂) values were not significantly different between the two groups (P > 0.05); the PaO₂ and PaCO₂ values in the refined care group were comparable to those in the routine care group after 7 d of intervention (P > 0.05). Before the intervention, there was no significant difference in the MRC score between the two groups (P > 0.05); the MRC score of the refined care group was lower than that of the routine care group after 7 d of intervention, but the difference was not statistically significant (P > 0.05). Before intervention, there was no significant difference in the symptoms, activities, disease impact, or St. George’s Respiratory questionnaire (SGRQ) total scores between the two groups (P > 0.05). After 7 days of intervention, the symptoms, activities, and total score of SGRQ of the refined care group were higher than those of the routine care group, but the difference was not statistically significant (P > 0.05).CONCLUSIONAECOPD with thick sputum, weak coughing reflex, and abnormal tracheal cilia function will lead to sputum accumulation and affect the exchange of oxygen and carbon dioxide in the lung. Patients with AECOPD who have difficulty expectorating sputum may undergo refined nursing strategies that will promote expectoration, alleviate clinical symptoms, and improve the quality of life.     

HRCT定量观察慢性阻塞性肺疾病患者支气管重构

目的 观察不同临床表型慢性阻塞性肺疾病(COPD)患者肺段和亚段支气管重构的差异。 方法 COPD患者76例,正常对照者30名(正常组),均接受胸部HRCT检查。对双上肺尖后段及亚段、双下肺后基底段及亚段支气管进行定量分析,分别测量4支段和4支亚段支气管的壁厚度(WT)、腔内径(Din)、壁面积(WA)和壁面积百分比(WA%),比较组间各指标差异。 结果 76例COPD患者分为支气管炎型(A组,41例)和肺气肿型(B组,35例)2种临床表型。A组表现为支气管管壁增厚和管腔变窄,以亚段支气管明显;B组表现为肺密度减低和肺气肿,支气管壁增厚不明显或轻度增厚。A、B两组段和亚段支气管WT大于正常组(P<0.05),段支气管Din小于正常组,A组亚段支气管Din小于正常组,差异有统计学意义(P<0.01),A、B两组间差异也有统计学意义(P<0.05)。A组段和亚段支气管WA大于正常组(P<0.05)。A、B两组段和亚段支气管WA%大于正常组(P<0.05),亚段支气管WA%显著大于段支气管(P<0.05)。 结论 HRCT能够检测段和亚段支气管重构,有助于诊断COPD患者临床表型。     

慢性阻塞性肺疾病和支气管哮喘生理评分在疾病急性加重期护理中的应用价值

目的 探讨慢性阻塞性肺疾病和支气管哮喘生理评分(the COPD and Asthma Physiology Score,CAPS)能否正确评估慢性阻塞性肺疾病急性加重期(AECOPD)患者病情的严重性和预后,指导治疗和护理计划的制定.方法 对我科2008年9月～2010年5月住院的AECOPD患者进行回顾性分析和CA...     

Combined effect of pulmonary rehabilitation and music therapy in patients with chronic obstructive pulmonary disease

[Purpose] We aimed to analyze parameters of pulmonary function and physiological, psychological, and physical factors in patients with chronic obstructive pulmonary disease (COPD) receiving pulmonary rehabilitation (PR) and music therapy (MT). [Participants and Methods] This randomized crossover comparative study included in-patients diagnosed with COPD and a ratio of forced expiratory volume measured at the first second and forced vital capacity (FEV1/FVC) of <70% after administration of a bronchodilator. Patients were randomly divided into two groups that received either PR only or MT and PR (n=13 each). The PR program included conditioning, respiratory muscle training, and endurance training, whereas the MT program included vocal, singing, and breathing exercises using a keyboard harmonica. The programs lasted 8 weeks, in which pre- and post-intervention data were compared every 4 weeks. [Results] The FEV1/FVC in the MT group improved after the intervention. Expiratory volume control was obtained better with feedback by sound than with expiration practice. In the MT and PR program, it was easier to adjust the timing and volume of breathing, obtain expiratory volume control, and, thus, improve FEV1/FVC than in conventional practice. [Conclusion] Combining MT with PR improves parameters of pulmonary function in patients with COPD. Music therapy is a novel approach that, in combination with PR, may be used in COPD management.     

康复治疗对慢性阻塞性肺疾病患者肺功能影响的临床调查

目的观察康复治疗对慢性阻塞性肺疾病(COPD)患者肺功能的影响。方法将2003年1月~2004年1月在深圳第四人民医院就诊的30例COPD患者随机分为训练组和对照组,各15例,训练组除基本治疗外,每天需进行多项康复治疗。对照组进行常规对症治疗及一般的肢体活动,治疗前及治疗后24周分别检查两组肺功能,并进行评估。结果治疗前两组肺功能评分无统计学意义(P>0.05)。治疗组治疗后肺功能较治疗前及对照组治疗后明显改善(P<0.05)。结论康复治疗能明显改善COPD患者的肺功能。     

持续护理在慢性阻塞性肺疾病患者中的应用效果

目的：探讨持续护理在慢性阻塞性肺疾病患者中的应用效果.方法：选择2010年3月～2013年2月我院慢性阻塞性肺疾病患者105例作为研究对象,将其随机分为A组52例和B组53例.A组患者接受常规护理,B组患者接受持续护理,对比两组患者情绪状态、护理风险事件发生率.结果：B组患者焦虑、抑郁评分均低于A组（P＜0.05）,护理风险事件发生率亦低于A组（P＜0.05）.结论：在慢性阻塞性肺疾病的临床治疗过程中实施持续护理,有助于改善患者的情绪状态,避免或减少护理风险事件,对促进患者康复具有积极的临床意义.     

两种排痰法在COPD患者应用中的效果比较

目的探讨雾化吸入配合使用G5振动排痰机对COPD患者排痰效果的影响。方法将36例随机分为实验组和对照组,实验组18例,接受雾化吸入配合G5振动排痰机辅助排痰法;对照组18例,单纯使用G5振动排痰机辅助排痰法。对两组1周内日排痰量及1周后不吸氧情况下的SPO2以及FEV1%预计值进行比较。结果实验组早期排痰量较对照组明显增加(P<0.05),晚期排痰量较对照组明显减少(P<0.05);在不吸氧情况下SPO2较对照组显著提高(P<0.01),FEV1%预计值较对照组明显提高(P<0.05)。结论雾化吸入配合G5振动排痰机辅助排痰法优于单纯使用G5振动排痰机辅助排痰法。     

吸入糖皮质激素治疗慢性阻塞性肺疾病的研究

目的探讨中等剂量二丙酸氯地米松短疗程吸入治疗慢性阻塞性肺疾病稳定期患者的疗效。方法按照随机、对照、单盲的设计,将44例稳定期慢性阻塞性肺疾病患者分2组,观察组给予二丙酸氯地米松(800μg/d)与对照组给予安慰剂吸入治疗6周,观察治疗前后测定肺功能第1秒用力呼气量、用力肺活量,并记录临床症状评分及生活质量评分。结果观察组21例,临床症状改善,治疗前症状评分为(5.1±0.5)分,治疗后为(4.6±0.4)分(P<0.05);第1秒用力呼气量治疗前为(1.79±0.02)L,治疗后为(2.16±0.03)L(P<0.01);用力肺活量治疗前为(2.20±0.02)L,治疗后为(2.50±0.03)L(P<0.05),呼吸功能提高显著。对照组19例,治疗前后各项指标均无显著性差异(P>0.05)。结论短期二丙酸氯地米松吸入治疗稳定期慢性阻塞性肺疾病患者可缓解临床症状,提高肺功能和生活质量。