主动呼吸循环技术训练联合系列排痰训练在老年脑卒中患者气管切开术后合并肺部感染中的康复效果

摘要 目的：观察主动呼吸循环技术训练（ACBT）联合系列排痰训练在老年脑卒中患者气管切开术后合并肺部感染中的康复效果。方法：选取2020年5月~2022年2月期间在长沙市第三医院老年医学科住院的63例老年脑卒中气管切开术后合并肺部感染患者。将入选的患者采用随机数字表法分为对照组和研究组，例数分别为31例和32例。对照组给予常规治疗结合系列排痰训练，研究组在对照组的基础上结合ACBT，对比两组临床症状、肺功能指标用力肺活量（FVC）、每分钟最大通气量（MVV）及呼气峰流速（PEF）]、血气分析指标血氧分压（PO₂）、血氧饱和度（SaO₂）、血二氧化碳分压（PaCO₂）]、炎症因子降钙素原（PCT）、C反应蛋白（CRP）、白细胞介素-6（IL-6）]水平。结果：研究组的日吸痰次数少于对照组，感染窗控制时间、拔管时间短于对照组，临床肺部感染评分（CPIS）评分小于对照组（P<0.05）。治疗4周后研究组FVC、MVV、PEF高于对照组（P<0.05）。治疗4周后研究组PO₂、SaO₂高于对照组，PaCO₂低于对照组（P<0.05）。治疗4周后研究组PCT、CRP、IL-6低于对照组（P<0.05）。结论：ACBT联合系列排痰训练应用于老年脑卒中患者气管切开术后合并肺部感染，可改善患者临床症状、肺功能、血气分析指标和炎症因子水平。

Rehabilitation Effect of Active Cycle of Breathing Technique Combined with a Series of Expectoration Training in Elderly Stroke Patients with Pulmonary Infection after Tracheotomy

ABSTRACT Objective: To observe the rehabilitation effect of active cycle of breathing technique (ACBT) combined with a series of expectoration training in elderly stroke patients with pulmonary infection after tracheotomy. Methods: 63 elderly stroke patients with pulmonary infection after tracheotomy who were hospitalized in Department of Geriatric Medicine of Changsha Third Hospital from May 2020 to February 2022 were selected. The enrolled patients were divided into control group and study group by random number table method, with 31 cases and 32 cases respectively. The control group was given conventional treatment combined with a series of expectoration training, and the study group was combined with ACBT on the basis of the control group. The clinical symptoms, pulmonary function indexes forced vital capacity (FVC), maximum ventilation volume per minute (MVV) and peak expiratory flow (PEF)], blood gas analysis indexes partial oxygen pressure (PO₂), oxygen saturation (SaO₂), partial carbon dioxide pressure (PaCO₂)], inflammatory factors procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)] in the two groups were compared. Results: The daily sputum aspiration times in the study group was less than that in the control group, the infection window control time and extubation time were shorter than those in the control group, and the clinical pulmonary infection score (CPIS) score was lower than that in the control group (P<0.05). 4 weeks after treatment, the FVC, MVV and PEF in the study group were higher than those in the control group (P<0.05). 4 weeks after treatment, PO₂ and SaO₂ in the study group were higher than those in the control group, while PaCO₂ was lower than that in the control group (P<0.05). 4 weeks after treatment, PCT, CRP and IL-6 in the study group were lower than those in the control group (P<0.05). Conclusion: The application of ACBT combined with a series of expectoration training in elderly stroke patients with pulmonary infection after tracheotomy can improve the clinical symptoms, pulmonary function, blood gas analysis index, and the level of inflammatory factors.