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目的探讨在NCPAP辅助治疗毛细支气管炎并呼吸功能不全治疗中,对比多频振动治疗仪排痰和人工排痰的气道护理效果。方法采取随机对照方法,将180例符合毛细支气管炎并呼吸功能不全诊断标准的患儿分为3组,A组采用多频振动排痰,B组采用人工排痰,C组多频振动治疗仪排痰和人工排痰相结合。3组患儿均予NCPAP供氧呼吸支持,常规抗感染,均予3%氯化钠液4 mL和布地奈德混悬液0.5 mg氧驱动雾化吸入,雾化次数及间隔时间相同,在应用多频振动治疗仪或人工叩背5～10 min后吸排痰。结果多频振动排痰与人工叩背方法相比,在排痰后2组血气分析各项指标比较差异有统计学意义(P<0.01),2种排痰方式有机结合后,在咳喘减轻时间,肺部听诊改善所需时间、NCPAP辅助通气时间上与人工排痰的比较,差异有统计学意义(P<0.01)。结论多频振动排痰可促进毛细支气管炎患儿肺内分泌物的排出,改善患儿肺部通气,PaO2升高,降低PaCO2,与传统人工排痰相结合,可以有效畅通气道,缩短鼻塞式CPAP应用时间,减少住院天数。
Objective To investigate the airway nursing effects of sputum aspiration and artificial sputum aspiration in the treatment of bronchiolitis and respiratory insufficiency with NCPAP adjuvant therapy. Methods A total of 180 children with bronchiolitis and respiratory insufficiency were divided into three groups according to a randomized controlled trial. Group A received multi-frequency vibration sputum aspiration, group B received artificial sputum aspiration, and group C multi-frequency vibration therapeutic apparatus Phlegm and artificial sputum combined. All three groups were given NCPAP oxygen breathing support, conventional anti-infection, were given 3% sodium chloride solution and budesonide suspension 0.5 mg oxygen inhalation inhalation, the number of atomization and the same time interval between Application multi-frequency vibration therapy device or artificial call back 5 ~ 10 min after suction phlegm. Results Multi-frequency vibration sputum aspiration compared with artificial knocking method, the two groups after sputum sputum blood gas analysis of various indicators were statistically significant differences (P <0.01), two kinds of sputum excretion organic combination, relieve cough Time, auscultation of the lungs, time of NCPAP-assisted ventilation and artificial sputum aspiration, the difference was statistically significant (P <0.01). Conclusions Multi-frequency vibration and sputum aspiration can promote the discharge of pulmonary secretions in children with bronchiolitis, improve lung ventilation, increase PaO2 and decrease PaCO2 in children with bronchitis. Combined with traditional artificial sputum aspiration, it can effectively clear the airway and shorten the nasal congestion CPAP application time, reduce the number of hospital days.