正压振动排痰设备Acapella Duet对胸外科术后患者排痰和肺功能的影响.docVIP

正压振动排痰设备Acapella Duet对胸外科术后患者排痰和肺功能的影响 　　[摘要] 目的 分析正压振动排痰设备Acapella Duet改善胸外科术后患者排痰和肺功能的临床效果，探讨其临床应用价值。 方法 选取2015年5～10月上海交通大学附属第一人民医院胸外科收治的90例手术患者为研究对象，按照患者意愿将其分为试验组（n = 20）和对照组（n = 70），两组均给予常规术后处理措施，试验组加用Acapella Duet震荡排痰器辅助排痰，比较两组患者治疗前后排痰效果和肺功能变化。 结果 试验组术后4 d痰液颜色已转变为白色，黏稠度较稀且易咳出，此时对照组患者痰液仍为黄色，中度黏稠，咳出难度中等。试验组平均24 h排痰量显著高于对照组，拔管时间、住院时间显著短于对照组，差异均有统计学意义（P 0.05）。与术前比较，两组患者术后1周呼吸频率、动脉血二氧化碳分压均显著下降，血氧饱和度、pH值均显著上升（P 0.05），且试验组变化较对照组更为明显（P 0.05）。试验组肺部并发症发生率为10.0%，显著低于对照组（25.7%），差异有统计学意义（P 0.05）。 结论 短期应用Acapella Duet能显著提高患者排痰效果，缩短拔管时间及住院时间，促进通气障碍的改善，对术后并发症的防治具有积极作用，值得推广应用。 　　[关键词] Acapella Duet；振动排痰；正压呼气；胸外科；肺功能 　　[中图分类号] R472 [文献标识码] A [文章编号] 1673-7210（2016）05（b）-0158-05 　　[Abstract] Objective To analyze the effect of positive pressure vibration expectoration machine Acapella Duet on the sputum excretion and lung function of patients after thoracic surgery， and to explore its clinical application value. Methods Ninety cases of patients admitted to Department of Thoracic Surgery of the First Peoples Hospital Affiliated to Shanghai Jiao Tong University from May to October 2015 were selected and divided into experimental group （n = 20） and control group （n = 70） according to their wishes， both groups received routine postoperative treatment measures， while the experimental group was added with expectoration machine Acapella Duet for assist sputum excretion， then the effect of sputum excretion and lung function before and after treatment between the two groups were compared. Results Postoperative 4 days， the sputum color of experimental group turned into white， and the sputum viscosity was thin and easy to cough out， while the sputum color of control group was still yellow， the sputum viscosity was moderate sticky and moderate difficult to cough out. The mean 24 h sputum volume of experimental group was higher than that of control group， and the extubation time and hospital stay were significantly shorter than those of control group， the differences were all statis