改良式胸部叩击联合无创吸痰技术在婴儿急性毛细支气管炎治疗中的效果

李海燕; 赵广云; 彭万胜

doi:10.16766/j.cnki.issn.1674-4152.002548

改良式胸部叩击联合无创吸痰技术在婴儿急性毛细支气管炎治疗中的效果

doi: 10.16766/j.cnki.issn.1674-4152.002548

1.
安徽医科大学附属六安医院六安市人民医院儿科，安徽六安 237000
2.
蚌埠医学院第一附属医院儿科，安徽蚌埠 233004

基金项目:

安徽省高校自然科学研究重点项目 KJ2019A0365

详细信息

通讯作者:
赵广云, E-mail: wangrui9516@163.com

中图分类号: R725.6
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- 文章访问数: 160
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- 被引次数: 0
出版历程
- 收稿日期: 2021-09-10
- 网络出版日期: 2022-09-23

Effect of modified chest percussion combined with non-invasive sputum suction technique in the treatment of infants with acute bronchiolitis

1.
Department of Pediatrics, Lu'an Hospital Affiliated to Anhui Medical University, Lu'an People's Hospital, Lu'An, AnHui 237000, China

摘要

摘要: 目的探讨在急性毛细支气管炎患儿中应用改良式胸部叩击联合无创吸痰技术治疗方法的可行性和有效性方法选择2019年12月—2020年12月在六安市人民医院儿科六病区住院的90例急性毛细支气管炎患儿，采用随机数表法将患儿分为观察组(48例)、对照组(42例)。2组患儿均采取常规的抗炎、雾化吸入等对症支持治疗，对照组采用常规叩击联合传统吸痰技术，观察组采用改良式胸部叩击联合无创吸痰技术。对比2组患儿治疗前后排痰效果、临床症状、呼吸功能等各项指标，比较2组治疗效果。结果观察组排痰效果优于对照组，其中观察组仅2例无效，有效率为95.83%，对照组10例无效，有效率为76.19%(χ²=7.479，P=0.006)；观察组咳喘、憋气、肺部啰音和住院时间等与对照组比较差异有统计学意义(均P＜0.05)；观察组呼吸功能指标均优于对照组(均P＜0.05)；观察组黏膜损伤发生率为2.08%(1/48)，明显低于对照组的28.57%(12/42，P＜0.05)；观察组患儿家长满意度高于对照组(P＜0.05)。结论改良式胸部叩击联合无创吸痰技术应用于婴儿急性毛细支气管炎，可显著提高患儿治疗效果，快速解除气道阻塞、减轻喘息症状、改善呼吸功能、减少吸痰并发症的发生、缩短住院时间，从而减轻患儿痛苦，提高家长满意度，且操作方便，值得推广。
- 改良式胸部叩击 /
- 无创吸痰技术 /
- 毛细支气管炎 /
- 治疗效果
Abstract: Objective To discuss the advisability and validity of modified chest percussion combined with non-invasive sputum suction technique in children with acute bronchiolitis. Methods Total 90 children with acute bronchiolitis hospitalized in the sixth ward of the Pediatrics Department of Lu'an People's Hospital from December 2019 to December 2020 were selected and divided into observation group (48 cases) and control group (42 cases) using tables of random numbers. The two groups were both cured with classical anti-inflammatory, atomized inhalation, and other symptomatic and supportive treatments. The conventional percussion combined with the traditional sputum suction technique were used for the control group, by contrast, modified chest percussion with the non-invasive sputum suction technique were used for the observation group. The sputum excretion effect, clinical symptoms, respiratory function and other indexes of the two groups were compared before and after treatment. The therapeutic effects of the two groups were compared. Results The sputum expectoration effect of the observation group was better than that of the control group. Only 2 cases in the observation group were ineffective, the effective rate was 95.83%, and 10 cases in the control group were ineffective, the effective rate was 76.19% (χ²=7.479, P=0.006). There were significant differences in cough, wheezing, breath holding, lung rales and hospital stay between the observation group and the control group (all P < 0.05). The indexes of respiratory function in the observation group were better than those in the control group (all P < 0.05). The incidence of mucosal injury in the observation group was 2.08% (1/48), which was significantly lower than 28.57% (12/42, P < 0.05). The satisfaction of parents in the observation group was higher than that in the control group (P < 0.05). Conclusion The modified chest percussion combined with non-invasive sputum suction technology in infants with acute bronchiolitis can significantly improve the therapeutic effect of children with acute bronchiolitis, quickly relieve children's airway obstruction, relieve children's wheezing symptoms, improve children's respiratory function, and reduce the incidence of sputum suction complications, shortening the hospital stay. It can alleviate the suffering of children, improve the satisfaction of parents, and the operation is convenient, which is worthy of promotion.
- Modified chest percussion /
- Non-invasive sputum suction technique /
- Bronchiolitis /
- Treatment effect

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表 1 2组急性毛细支气管炎患儿排痰效果比较

Table 1. Comparison of expectoration effect of two groups of children with acute bronchiolitis

组别	例数	痊愈(例)	显效(例)	进步(例)	无效(例)	总有效率(%)
观察组	48	35	2	9	2	95.83(46/48)
对照组	42	22	10	0	10	76.19(32/42)
注：2组总有效率比较，χ²=7.479，P=0.006。

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表 2 2组急性毛细支气管炎患儿临床症状减轻时间及住院时间比较(x±s, d)

Table 2. Comparison of clinical symptom relief time and hospitalization time in two groups of children with acute bronchiolitis

组别	例数	咳嗽缓解时间	喘憋缓解时间	痰鸣音消失时间	肺部啰音消失时间	住院时间
观察组	48	4.29±1.24	3.29±0.97	4.56±1.09	4.60±1.05	6.29±1.18
对照组	42	5.71±1.77	4.31±1.14	5.79±1.79	6.07±1.69	8.36±1.10
t值		-4.358	-4.542	-3.852	-4.718	-8.573
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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表 3 2组急性毛细支气管炎患儿呼吸功能指标比较(x±s)

Table 3. Comparison of respiratory function indexes between two groups of children with acute bronchiolitis

组别	例数	呼吸频率(次/min)		经皮血氧饱和度(%)
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	48	47.06±2.26	31.98±1.64^a	90.29±1.90	96.23±2.07^a
对照组	42	47.17±2.06	35.93±2.19^a	90.09±1.92	93.19±1.92^a
t值		-0.229	-9.563	-0.486	7.238
P值		0.820	＜0.001	0.628	＜0.001
注：与同组治疗前比较，^aP＜0.01。

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表 4 2组急性毛细支气管炎患儿黏膜损伤情况以及家长满意度比较

Table 4. Comparison of mucosal damage and parental satisfaction in children with acute bronchiolitis between two groups

组别	例数	黏膜损伤情况(例)		满意度评分(x±s, 分)
组别	例数	有	无	满意度评分(x±s, 分)
观察组	48	1	47	9.41±0.71
对照组	42	12	30	8.67±1.51
统计量		12.717^a		2.949^b
P值		＜0.001		0.005
注：^a为χ²值，^b为t值。

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