陈畏兵 马红梅

[摘要] 目的 研究G5體外振动排痰仪为老年慢性阻塞性肺疾病（COPD）合并肺部感染患者排痰时的最佳单次治疗时间，探讨最佳辅助排痰治疗方案。 方法2014年1月～2015年9月选取武汉大学人民医院收治的老年COPD合并肺部感染患者396例作为研究对象。依照排痰方式分为对照组（人工叩击组，n=132），10 min组（G5体外振动排痰仪每次治疗时间10 min，n=132），20 min组（G5体外振动排痰仪每次治疗时间20 min，n=132）。比较三组患者的排痰情况、肺功能改变、治疗副作用及护士疲劳度。 结果 20 min组患者24 h痰量高于10 min组和对照组，体温恢复正常时间、血常规恢复正常时间均短于10 min组和对照组，差异均有统计学意义（P < 0.05）；20 min组患者治疗后肺功能指标FVC、FEV1、FEV1%明显高于对照组和10 min组，差异均有统计学意义（P < 0.05）；护士治疗疲劳程度10 min与20 min组低于对照组，差异有统计学意义（P < 0.05），10 min组与20min组比较差异无统计学意义（P > 0.05）；三组患者治疗后烦躁、呼吸急促、呼吸困难、副作用总发生率差异无统计学意义（P > 0.05）。 结论 G5体外振动排痰仪单次治疗20 min的排痰效果优于单次治疗10 min及传统人工叩击法，且治疗时患者无明显副作用发生，值得临床推广。

[关键词] 排痰；老年人；肺部感染；肺功能；治疗时间

[中图分类号] R563 [文献标识码] A [文章编号] 1673-7210（2016）02（b）-0137-04

The best single treatment time of G5 external vibration sputum elimination instrument for sputum elimination of elderly patients combined with COPD and pulmonary infection

CHEN Weibing MA Hongmei▲

Department of Geriatrics， the People's Hospital of Wuhan University， Hubei Province， Wuhan 430060， China

[Abstract] Objective To investigate the best single treatment time of G5 external vibration sputum elimination instrument for sputum elimination of elderly patients combined with COPD and pulmonary infection， and to explore the best auxiliary sputum elimination therapeutic schedule. Methods 396 cases of elderly patients with COPD combined with pulmonary infection in the People's Hospital of Wuhan University from January 2014 to September 2015 were selected as the research objects. According to the sputum elimination way， patients were divided into the control group （artificial beating group， n=132）， 10 min group （treatment time of 10 min for every time by G5 external vibration sputum elimination instrument， n=132） and 20 min group （treatment time of 20 min for every time by G5 external vibration sputum elimination instrument， n=132）. The sputum elimination condition， change of lung function， treatment side effects of patients and fatigue of nurses among the three groups were compared. Results The 24 h sputum volume of the 20 min group was higher than that of the 10 min group and the control group， and the time of temperature returned to normal， blood routine returned to normal of the 20 min group were shorter than those of the 10 min group and the control group， with statistically significant differences （P < 0.05）. The lung function indices of FVC， FEV1， FEV1% in the 20 min group were higher than those of the 10 min group and the control group， with statistically significant differences （P < 0.05）. The fatigue of nurses in 10 min group and 20 min group was lower than that in the control group （P < 0.05）， but between the 10 min group and 20 min group had no significant difference （P > 0.05）. The incidence of dysphoria， polypnea， dyspnea and total incidence of side effects among the three groups had no significant difference （P > 0.05）. Conclusion The effects of sputum elimination by G5 external vibration sputum elimination instrument treatment for 20 min are better than treatment for 10 min and artificial beating， and had no obvious side effects. It is worthy of clinical application.

[Key words] Sputum elimination； The elderly； Lung infection； Lung function； Treatment time

隨着我国人口的老龄化，老年慢性阻塞性肺疾病（COPD）患者呈逐年上升的趋势[1]。刘英[2]研究数据显示，COPD合并肺部感染是老年人最常见的感染性疾病，所占比例为48.73%。老年人常因呼吸系统退行性改变、呼吸道黏膜纤毛运动减弱、咳痰反射迟钝及无力等使得痰液排泄不畅阻塞气道[3]，影响患者通气功能，导致肺部感染。清除呼吸道分泌物对于老年COPD合并肺部感染的治疗至关重要[4]。目前体外振动排痰仪代替人工扣击排痰已在临床中广泛应用，并取得很好的疗效[5]，但其单次治疗时间，目前各大医院和厂家并没有统一的规定[6]。厂家……