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目的:观察阶段式肺康复锻炼对重症肺炎患儿肺功能、康复速度及家属满意度的影响。方法:回顾性分析2023年1月—2024年12月就诊于宜昌市中心人民医院的308例重症肺炎患儿的临床资料,将2023年1月—2023年12月收治的150例患儿纳入对照组,给予常规护理;将2024年1月—2024年12月收治的158例患儿纳入观察组,观察组在对照组的基础上进行阶段式肺康复锻炼。比较两组患儿的用力肺活量(FVC)占预计值百分比(FVC%)、第一秒用力呼气容积(FEV1)/FVC、止咳时间、肺啰音消失时间、住院时间及患儿家属满意度。结果:与对照组相比,观察组患儿干预后FVC%[(80.78±4.26)%vs (75.32±5.22)%]和FEV1/FVC[(93.65±5.26)%vs (81.21±5.12%)]均明显升高(均P<0.05)。观察组患儿止咳时间[(3.79±0.97) d vs (6.05±1.27) d]、肺啰音消失时间[(4.35±1.29) d vs (7.28±1.29) d]、住院时间[(11.28±2.81) d vs (15.74±3.51) d]较对照组均明显缩短(均P<0.05)。观察组患儿家属满意明显高于对照组(93.67%vs 72.67%)(P<0.05)。结论:阶段式肺康复锻炼可有效改善重症肺炎患儿肺功能,缩短康复时间,提高患儿家属满意度,值得临床推广应用。
Abstract：Objective: To observe the impact of phased pulmonary rehabilitation exercises on lung function, recovery speed, and family satisfaction in children with severe pneumonia. Methods: A retrospective analysis was conducted on the clinical data of 308 children with severe pneumonia who were treated at Yichang Central People's Hospital between January 2023 and December 2024. A total of 150 children admitted between January 2023 and December 2023 were included in the control group and received conventional nursing care. Meanwhile, 158 children admitted between January 2024 and December 2024 were included in the observation group, and underwent phased pulmonary rehabilitation exercises in addition to conventional care. The two groups were compared in terms of the percentage of forced vital capacity(FVC) to predicted values, the ratio of forced expiratory volume in one second(FEV1) to FVC, time to cessation of coughing, time for lung rales to disappear, length of hospital stay, and family member satisfaction. Results: Compared with the control group, the observation group demonstrated significantly higher post intervention FVC% [(80.78±4.26)%vs(75.32±5.22)%] and FEV1/FVC [(93.65±5.26)% vs(81.21±5.12)%](both P<0.05). Furthermore, The observation group showed significantly shorter times for cessation of coughing [(3.79±0.97) d vs(6.05±1.27) d], disappearance of lung rales [(4.35±1.29) d vs(7.28±1.29) d], and hospital stay [(11.28±2.81) d vs(15.74±3.51) d] compared to the control group(all P<0.05). Family member satisfaction was also significantly higher in the observation group than in the control group(93.67% vs 72.67%, P<0.05). Conclusion: Phased pulmonary rehabilitation exercises can effectively improve lung function, shorten recovery time, and increase family member satisfaction in children with severe pneumonia, making it a valuable approach for clinical promotion and application.
[1] Wang X, He H A, Zheng J L, et al. A comparison of efficacy and safety of complementary and alternative therapies for severe Mycoplasma pneumonia in children:a protocol for systematic review and meta-analysis[J].Medicine(Baltimore), 2021, 100(7):e23959.
[2]史小慧,曾晓兵,康莉莉,等.儿童重症肺炎进展风险预测模型构建[J].赤峰学院学报(自然科学版), 2024,40(8):13-17.
[3] GBD 2015 LRI Collaborators. Estimates of the global,regional, and national morbidity, mortality, and aetiologies of lower respiratory tract infections in 195countries:a systematic analysis for the Global Burden of Disease Study 2015[J]. Lancet Infect Dis, 2017, 17(11):1133-1161.
[4]周丽,王淼,董晓艳. 5岁及以下儿童社区获得性肺炎进展为重症肺炎的流行病学特点[J].上海医学,2023, 46(7):465-470.
[5]刘晓萍,黄义双,黄卫东,等.儿童社区获得性肺炎进展为重症肺炎的风险预测[J].兰州大学学报(医学版),2022, 48(5):67-71.
[6]宋哲,贾广媛,王晓,等.茵芩清肺颗粒联合西医常规疗法治疗儿童重症肺炎支原体肺炎湿毒闭肺证的临床疗效观察[J].中华中医药杂志, 2024, 39(5):2662-2667.
[7]李勤勤,彭东红.经鼻持续气道正压通气治疗的儿童重症肺炎病原学分析[J].儿科药学杂志, 2021, 27(5):9-11.
[8]彭万胜,刘恩梅.糖皮质激素治疗儿童重症肺炎支原体肺炎研究进展[J].蚌埠医学院学报, 2019, 44(5):695-697.
[9]唐晓燕,蒋小辉,韦靖,等.儿童呼吸系统疾病肺康复护理研究进展[J].中国临床护理, 2023, 15(7):446-449.
[10]赵元会,巨海春.集束化护理在儿科重症监护病房重症肺炎患儿中的应用效果及对凝血指标的影响[J].血栓与止血学, 2021, 27(5):894-895.
[11]宋桂华,孙萌萌,张冰雪,等.儿童重症肺炎肺康复中西医结合诊疗方案专家共识[J].中华中医药学刊,2025, 43(1):253-258.
[12]van der Schaaf M, Beelen A, Dongelmans D A, et al.Functional status after intensive care:a challenge for rehabilitation professionals to improve outcome[J]. J Rehabil Med, 2009, 41(5):360-366.
[13]黄晓波,王丽芳,宋卓华,等.重症患儿进阶性心肺康复方案的应用及近期效果评价[J].中华急危重症护理杂志, 2020, 1(5):431-436.
[14]刘春莉,武元,陈炯,等.综合肺康复疗法对肺炎后儿童肺功能及运动功能影响的前瞻性非随机对照研究[J].中国康复医学杂志, 2024, 39(9):1316-1320.
[15]中国医师协会急诊医师分会.中国急诊重症肺炎临床实践专家共识[J].中国急救医学, 2016, 36(2):97-107.
[16]王龙,王广军,梁群.重症肺炎发病机制及中西医治疗研究进展[J].长春中医药大学学报, 2023, 39(11):1275-1279.
[17]高志,孙照祝.重症肺炎的呼吸支持治疗进展[J].中国医刊, 2021, 56(9):946-948.
[18]李娅,柳轮,卢群叶.“3H”理论下的全方位护理在重症肺炎患儿中的应用效果及对康复速度的影响[J].临床医学研究与实践, 2024, 9(1):157-160.
[19]胡亚美,江载芳.诸福棠实用儿科学[M]. 7版.北京:人民卫生出版社, 2002:2709.
[20]刘金荣,赵成松,赵顺英.《儿童社区获得性肺炎诊疗规范(2019年版)》解读[J].中国实用儿科杂志, 2020, 35(3):185-187.
[21]武亮,董继革,郭琪,等.中国社区心肺康复治疗技术专家共识[J].中国老年保健医学, 2018, 16(3):41-51.
[22]陈盼盼.激励理论视角下儿童呼吸训练产品设计研究[D].江苏:南京理工大学, 2023.
[23]常洁,韩志英.儿童肺康复治疗方法的合理应用[J].中国实用儿科杂志, 2021, 36(3):199-201.
[24]Ren S, Li W, Wang L, et al. Numerical analysis of airway mucus clearance effectiveness using assisted coughing techniques[J]. Sci Rep, 2020, 10(1):2030.
[25]Zorc J J,Hall C B.Bronchiolitis:recent evidence on diagnosis and management[J].Pediatrics,2010,125(2):342-349.
[26]祝文艳,李晓敏无创气道咳痰机辅助咳痰无效患者排痰效果观察[J].临床医药文献电子杂志,2018,5(46):54.
[27]马玥.振动排痰联合纤维支气管镜肺灌洗治疗重症肺炎机械通气患者的临床疗效[J].中国医疗器械信息,2020,26(3):107-109.
[28]Masoompou r M,Anushiravani A,Tafaroj Norouz A.Evaluationof the effect ofnebulized N-acetylcysteine on respirator y secretions in mechanically ventilated patients:randomized clinical trial[J].Iran Med Sci,2015,40(4):309-315.
[29]邓三于,李子锋,常彩云生姜推拿结合拔罐治疗风寒感冒后咳嗽的疗效观察[J].巴楚医学,2025,8(1):104-108.
[30]田中燕,刘晓佳,刘伟然,等穴位贴敷联合孟鲁司特钠片、布地奈德气雾剂对儿童支气管哮喘急性期患者肺功能及血清炎症因子水平的影响[J].河北中医,2023,45(2):236-239.
[31]Carew C,Cox W.Laps or lengths The effects of differentexercise programs on asthma controli children[J].J Asthma,2018,55(8):877-881.
[32]PuhanM A,Büsching G,Schünemann J,et al.Interval versus continuous high-intensity exercise in chronic obstructive pulmonary disease:a randomized trial[J].Ann Intern Med,2006,145(11):816-825.
[33]Türk Y,van Huisstede A,Franssen F M E,et al.Effectof an outpatient pulmonary rehabilitation program onexercise tolerance and asthma controli obese asthma patients[J].J Cardiopulm Rehabil Prev,2017,37(3):214-222.
[34]中华医学会儿科学分会呼吸学组肺功能协作组,《中华实用儿科临床杂志》编辑委员会.儿童肺功能系列指南(二):肺容积和通气功能[J].中华实用儿科临床杂志,2016,31(10):744-750.
[35]Zhang J,Wang Q,Liu L L,et al.Effects of physical therapy on lung function in children with asthma:systematicreview and me ta-analysis[J].PediatrRes,2021,89(6):1343-1351.
[36]Siriwat R,Deerojanawong J,Sritippayawan S,et al.Mechanical insufflation-exsufflationversus conventional chest physiotherapy in children with cerebral palsy[J].RespirCare,2018,63(2):187-193.
[37]孙德仁,夏慧萍,王建红少儿推拿的作用机制与临床应用[J].中国民间疗法,2019,27(4):11-13.
[38]祁颂可.罗伊适应模式护理在呼吸衰竭重症监护患儿中的应用效果[J].中国民康医学,2025,37(4):194-196.
基本信息:
中图分类号:R473.72
引用信息:
[1]刘会琴,李子锋,席祖洋,等.阶段式肺康复锻炼在重症肺炎患儿中的临床疗效观察[J].巴楚医学,2025,8(02):37-44.
基金信息:
湖北儿科联盟医学科研项目(HBPAMRP202116); 宜昌市医疗卫生研究项目(A20-2-012)
2025-06-27
2025-06-27