Application of mechanical insufflation-exsufflation combined with external diaphragm pacemaker in elderly patients with mechanical ventilation
10.3760/cma.j.cn115682-20200517-03395
- VernacularTitle:机械性吸-呼气排痰技术联合体外膈肌起搏技术在高龄老年机械通气患者中的应用
- Author:
Jing ZHAO
1
;
Huiru HOU
;
Zhijian ZHANG
;
Chunyun LAI
;
Shuping WU
;
Juanli WANG
Author Information
1. 解放军总医院第二医学中心呼吸与危重症医学科，北京 100853
- Keywords:
Aged;
Mechanical ventilation;
Mechanical insufflation-exsufflation;
External diaphragm pacemaker
- From:
Chinese Journal of Modern Nursing
2020;26(30):4156-4160
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the suitability of mechanical insufflation-exsufflation combined with external diaphragm pacemaker in elderly patients with mechanical ventilation and its effect on the complications and prognosis of mechanical ventilation.Methods:Using the convenient sampling method, a total of 40 elderly patients undergoing mechanical ventilation through nasal tracheal intubation who were admitted to the Geriatric Ward of the PLA General Hospital from September 2018 to December 2019 were selected as the research objects. The patients were divided into the observation group and the control group by random number table method, with 20 cases in each group. The control group continued the traditional airway nursing technique and limb rehabilitation training, while the observation group added mechanical insufflation-exsufflation combined with external diaphragm pacemaker on the basis of the control group. The incidence of pulmonary infection, changes in sputum production at 1 h and 24 h, diaphragm thickening rate, weaning time, success rate of weaning and mortality rate were observed in the two groups before and after intervention.Results:After the intervention, the incidence of pulmonary infection in the observation group was lower than that of the control group, the sputum production and diaphragm thickening rate at 1 h and 24 h were higher than those in the control group, the weaning time was shorter than that of the control group, and the success rate of weaning was higher than that of the control group. All differences were statistically significant ( P<0.05) . There was no statistically significant difference in mortality rate between the two groups ( P>0.05) . Conclusions:Compared with traditional airway nursing techniques, mechanical insufflation-exsufflation combined with external diaphragm pacemaker can help elderly patients with mechanical ventilation achieve airway clearance and respiratory muscle exercise more safely and effectively, improve strength and endurance of diaphragmatic muscle and enhance the ability of spontaneous cough in elderly patients. In addition, the intervention method is mild and easy for patients to accept, and it is worthy of being widely used in elderly patients with mechanical ventilation.
