Breast Surgery Department, Jiangsu Province Hospital, and the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Neurosurgery Department, Jiangsu Province Hospital, and the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Medicine (Baltimore). 2024 Jul 5;103(27):e38783. doi: 10.1097/MD.0000000000038783.
The objective of this study is to assess the impact of an early-graded pulmonary rehabilitation training program on patients undergoing mechanical ventilation due to brainstem hemorrhage.
Eighty patients receiving mechanical ventilation due to brainstem hemorrhage at our hospital's neurosurgery department between August 2022 and October 2023 were enrolled as participants. A sampling table was generated based on the order of admission, and 80 random sequences were generated using SPSS software. These sequences were then sorted in ascending order, with the first half designated as the control group and the second half as the intervention group, each comprising 40 cases. The control group received standard nursing care for mechanical ventilation in brainstem hemorrhage cases, while the intervention group underwent early-graded pulmonary rehabilitation training in addition to standard care. This intervention was conducted in collaboration with a multidisciplinary respiratory critical care rehabilitation team. The study compared respiratory function indices, ventilator weaning success rates, ventilator-associated pneumonia incidence, mechanical ventilation duration, and patient discharge duration between the 2 groups.
The comparison between patients in the observation group and the control group regarding peak expiratory flow and maximum inspiratory pressure on days 1, 3, 5, and 7 revealed statistically significant differences (P < .05). Additionally, there was a statistically significant interaction between the main effect of intervention and the main effect of time (P < .05). The success rate of ventilator withdrawal was notably higher in the observation group (62.5%) compared to the control group (32.5%), with a statistically significant difference (P < .05). Moreover, the incidence rate of ventilator-associated pneumonia was significantly lower in the observation group (2.5%) compared to the control group (17.5%) (P < .05). Furthermore, both the duration of mechanical ventilation and hospitalization were significantly shorter in the observation group compared to the control group (P < .05).
Early-graded pulmonary rehabilitation training demonstrates effectiveness in enhancing respiratory function, augmenting the ventilator withdrawal success rate, and reducing both the duration of mechanical ventilation and hospitalization in mechanically ventilated patients with brainstem hemorrhage. These findings suggest the potential value of promoting the application of this intervention in clinical practice.
本研究旨在评估早期分级肺康复训练方案对因脑干出血接受机械通气的患者的影响。
2022 年 8 月至 2023 年 10 月，我院神经外科收治的 80 例因脑干出血接受机械通气的患者作为研究对象。采用入院顺序抽样表，使用 SPSS 软件生成 80 个随机序列，升序排序，前半部分设为对照组，后半部分为干预组，每组 40 例。对照组给予常规机械通气护理，干预组在常规护理的基础上进行早期分级肺康复训练，由多学科呼吸危重症康复治疗团队协作完成。比较两组患者的呼吸功能指标、呼吸机撤机成功率、呼吸机相关性肺炎发生率、机械通气时间和患者出院时间。
观察组与对照组患者在第 1、3、5、7 天的呼气峰流速和最大吸气压力比较，差异均有统计学意义（P ＜0.05）。两组间干预主效应与时间主效应间存在交互作用（P ＜0.05）。观察组呼吸机撤机成功率（62.5%）明显高于对照组（32.5%），差异有统计学意义（P ＜0.05）。观察组呼吸机相关性肺炎发生率（2.5%）明显低于对照组（17.5%），差异有统计学意义（P ＜0.05）。观察组机械通气时间和住院时间均明显短于对照组，差异有统计学意义（P ＜0.05）。
早期分级肺康复训练可有效改善呼吸功能，提高呼吸机撤机成功率，缩短机械通气时间和住院时间，对因脑干出血行机械通气的患者具有一定的临床应用价值。
