摘要
目的分析慢性阻塞性肺疾病(COPD)机械通气应用量化评估指导的四级康复联合高脂低糖肠内营养的效果。方法纳入2020年2月至2021年2月在南京医科大学附属淮安第一医院收治COPD患者110例,以随机数字表法分对照组和试验组,每组55例。对照组行高脂低糖肠内营养,试验组在对照组基础上行量化评估四级康复,比较两组血气指标、呼吸功能、免疫功能、脱机情况及训练前后神经功能评分。结果试验组动脉血氧分压、血氧饱和度高于对照组,二氧化碳分压低于对照组,用力肺活量、第1秒用力呼气容积、呼气峰值流速高于对照组,差异有统计学意义(P<0.05)。试验组免疫功能高于对照组,脱机时间短于对照组,脱机成功率高于对照组,差异有统计学意义(P<0.05)。训练后,两组转移、行进、交流、社会认知、自理能力、括约肌控制评分高于训练前,且试验组高于对照组,差异有统计学意义(P<0.05)。结论在COPD机械通气中应用量化评估指导的四级康复,改善其营养状态,缩短机械通气的时间,促进呼吸功能和神经功能快速康复。
Objective To analyze the effects of four-level rehabilitation guided by quantitative assessment combined with high-fat and low-glucose enteral nutrition on mechanical ventilation in chronic obstructive pulmonary disease(COPD).Methods A total of 110 COPD patients admitted to Huaian First Hospital Affiliated to Nanjing Medical University from February 2020 to February 2021 were included and divided into control group and experimental group by random number table method,with 55 cases in each group.The control group received high-fat and low-sugar enteral nutrition,and the experimental group received four-level rehabilitation guided by quantitative evaluation on the basis of the control group.The blood gas indexes,respiratory function,immune function,off-line situation,and neurological function scores before and after training were compared between the two groups.Results Partial pressure of oxygen in artery and pulse oxygen saturation in the experimental group were higher than those in the control group,partial pressure of carbon dioxide was lower than that in the control group,while forced vital capcacity,forced expiratory volume in the first second,and peak expiratory flow were higher than those in the control group,and the differences were statistically significant(P<0.05).The immune function of the experimental group was higher than that of the control group,the off-line time was shorter than that of the control group,while the success rate of off-line was higher than that of the control group,and the differences were statistically significant(P<0.05).After training,the scores of transfer,travel,communication,social cognition,self-care ability,and sphincter control in the two groups were higher than those before training,while the experimental group was higher than the control group,and the differences were statistically significant(P<0.05).Conclusion Applying the four-level rehabilitation guided by quantitative assessment in COPD mechanical ventilation can improve its nutritional status,shorten the time of mechanical ventilation,and promote the rapid recovery of respiratory function and neurological function.
作者
李敏敏
徐海霞
杨莉莉
LI Minmin;XU Haixia;YANG Lili(Department of Respiratory and Critical Care Medicine,Huaian First Affiliated Hospital of Nanjing Medical University,Jiangsu Province,Huaian 223300,China)
出处
《中国医药导报》
CAS
2022年第22期164-167,共4页
China Medical Herald
基金
江苏省自然科学基金青年项目(BK20190601)。
关键词
量化评估
四级康复护理
高脂低糖肠内营养
慢性阻塞性肺疾病
机械通气
Quantitative assessment
Four-level rehabilitation guided
High-fat and low-glucose enteral nutrition
Chronic obstructive pulmonary disease
Mechanical ventilation
