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目的探讨胸部物理疗法联合口咽通气管吸痰对行无创正压通气的支气管扩张症患者的治疗效果及安全性。方法选取2013年1月—2015年8月存在不同程度急性呼吸衰竭的急性加重期支气管扩张症患者27例,在给予抗菌药物治疗、对症治疗、营养支持的基础上行无创正压通气,护理上给予手法叩背、应用体外震动排痰机、体位引流等胸部物理疗法联合经口咽通气管吸痰。结果经综合治疗和护理后,患者最终显效16例,有效9例,无效2例,治疗有效率达92.6%。结论对伴有呼吸衰竭的支气管扩张症急性加重期患者,在实施无创正压通气时,用胸部物理疗法配合口咽通气管吸痰能解决无创正压通气中患者无力咳痰的问题,保持呼吸道通畅,保障无创正压通气的顺利实施,改善患者预后。
Objective To investigate the therapeutic effect and safety of thoracic physiotherapy combined with oropharyngeal ventilation tube suctioning on patients with bronchiectasis without invasive positive pressure ventilation. Methods Twenty-seven patients with acute exacerbation of bronchiectasis with varying degrees of acute respiratory failure from January 2013 to August 2015 were selected. Noninvasive positive pressure ventilation was given on the basis of antimicrobial treatment, symptomatic treatment and nutritional support, The method of knocking back, the application of vibrating sputum extracorporeal discharge machine, body position drainage and other chest physical therapy combined with oral pharyngeal ventilation tube suction sputum. Results After comprehensive treatment and nursing, the patients were markedly effective in 16 cases, effective in 9 cases, ineffective in 2 cases, and the effective rate was 92.6%. Conclusion In patients with acute exacerbation of bronchiectasis accompanied by respiratory failure, chest physical therapy combined with oropharyngeal ventilation tube suctioning can solve the problem of inability to expectoration in patients with non-invasive positive pressure ventilation during non-invasive positive pressure ventilation and maintain the respiratory tract Unobstructed to ensure the smooth implementation of noninvasive positive pressure ventilation, improve patient prognosis.