摘要
目的 探讨体外膈肌起搏器(EDP)联合气道廓清技术(ACT)对老年痴呆患者肺部感染的效果及对膈肌移动度和膈肌厚度的影响.方法 采用前瞻性研究,选择金华市第二医院2022年6月至2023年2月收治的老年痴呆合并肺部感染患者60例,采用随机数字表法将其分为观察组与对照组,各30例.对照组采用ACT治疗,观察组在ACT基础上采用EDP治疗.两组持续治疗4周.比较两组疗效以及治疗前后痰色评分、痰质评分、痰量、膈肌移动度和厚度.结果 观察组患者总有效率[93.33％(28/30)]高于对照组[73.33％(22/30)](Z=2.08,P=0.038).观察组治疗后痴呆合并肺部感染患者痰色评分[(0.46±0.12)分]、痰质评分[(0.34±0.10)分]和痰量[(8.47±1.23)mL]均低于对照组的(0.89±0.17)分、(0.76±0.18)分和(13.25±2.87)mL(t=11.32、11.17、8.38,均P＜0.001).观察组治疗后患者膈肌移动度[(13.52±0.51)mm]和膈肌厚度[(0.52±0.06)mm]均高于对照组的(12.76± 0.41)mm 和(0,44±0.04)mm(t=-6.36、-6.08,均P＜0.001).结论 EDP联合ACT对老年痴呆合并肺部感染患者疗效显著,可改善患者肺功能,提高膈肌移动度和膈肌厚度,减轻患者呼吸困难.
Abstract
Objective To investigate the efficacy of an extracorporeal diaphragm pacemaker(EDP)combined with airway clearance technology(ACT)in the treatment of pulmonary infection in older adult patients with dementia and its impact on diaphragmatic mobility and thickness.Methods A total of 60 patients with dementia and pulmonary infections who received treatment at The Second Hospital of Jinhua from June 2022 to February 2023 were included in this prospective study.These patients were randomly divided into an observation group and a control group,with 30 patients in each group.The control group received ACT treatment,while the obserYation group received EDP treatment on the basis of ACT treatment.Two groups were treated for 4 successive weeks,Efficacy was compared between the two groups.Before and after treatment,sputum color score,sputum quality score,diaphragmatic mobility,and diaphragmatic thickness were compared between the two groups.Results The overall response rate in the observation group was 93.33％(28/30),which was significantly higher than 73.33％(22/30)in the control group(Z=2.08,P=0.038).After treatment,the sputum color score,sputum quality score,and sputum volume in the observation group were(0.46±0.12)points,(0.34±0.10)points,and(8.47± 1.23)mL,respectively,which were significantly lower than(0.89±0.17)points,(0.76±0.18)points,and(13.25±2.87)mL,respectively,in the control group(t=11.32,11.17,8.38,all P＜0.001).After treatment,the diaphragmatic mobility and thickness in the observation group were(13.52±0.51)mm and(0.52±0.06)mm,respectively,which were significantly greater than(12.76±0.41)mm and(0.44±0.04)mm,respectively,in the control group(t=-6.36,-6.08,both P＜0.001).Conclusion The combined application of EDP and ACT shows a significant therapeutic effect on patients with dementia and pulmonary infection,effectively improving their pulmonary function,increasing the mobility and thickness of the diaphragm,and alleviating difficulties in breathing.
基金项目
浙江省金华市公益性技术应用研究项目(2022-4-171)
NETL
NSTL
维普
万方数据