呼吸物理治疗在降低重症监护病房获得性脑损伤患者慢性肺部感染评分 (CPIS) 中的作用:比较研究

Sachin Agarwal, Rajasekar S
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引用次数: 0

摘要

后天性脑损伤是指大脑受到损伤,导致主观、生理、热情和自主工作能力下降。后天性脑损伤可因外伤、缺氧、污染、肿瘤、药物处理、神经系统退行性疾病和中风而发生1,2。严重后天性颅脑损伤的特征是患者心肺复苏后 GCS 为 3-8,头部计算机断层扫描(CT)显示血肿、伤口、水肿和基底腔压迫3,4。CPIS 用于诊断和确定 VAP 的发生率。 临床肺部感染评分(CPIS)- 体温(℃)≥36.5 和≤38.4=0 分 ≥38.5 和≤38.9=1点 ≥39或≤36=2点 血白细胞计数(细胞/立方毫米)≥4,000且≤11,000=0点 11,000=1点+带状疱疹≥500=+1点 气管分泌物稀少=0点 中等/混浊但不脓性=1点 中等/混浊且脓性=2点 氧合:PaO2/FiO2>240或ARDS=0点 ≤240且无ARDS证据=2点 肺部放射摄影 无滤过液=0点 斑状/弥漫性滤过液=1点 局部滤过液=2点 气管吸出物培养(半定量定量) 培养出的病原菌≤1+或无生长=0点 培养出的病原菌>1+无生长=1点 同样的病原菌在革兰氏染色上>1+=2点 总分=CPIS(可能范围=0至12) 方法:呼吸理疗的应用包括体位疗法、人工充气疗法(MH)、气道抽吸疗法、PNF呼吸疗法、被动肢体运动疗法和早期活动疗法。结果显示结果显示,慢性肺部感染评分(CPIS)从入院时的降低到出院时的降低,P<.005:呼吸理疗使慢性肺部感染评分(CPIS)从入院时的降低到出院时的降低,改善了 ABI 患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of Respiratory Physiotherapy in reductionof Chronic Pulmonary Infection Score (CPIS) in Acquired Brain Injury Patients admitted in Intensive Care Unit: A Comparative Study
It was accounted for ABI as damage to the brain which brings about disintegration in subjective, physical, enthusiastic and autonomous working. Acquired brain injury can occur due to injury, hypoxia, contamination,tumor, substance manhandle, degenerative neurological sickness and stroke1,2. Serious ABI is characterized as a GCS of 3-8 after cardiopulmonary revival in a patient with an irregular computer tomography (CT) output of the head which shows haematomas, wounds, oedema, and compacted basal cisterns3,4. The definitions gave in this passage were embraced for use in this ABI investigation.CPIS was used to diagnose and determine the incidence of VAP.   Clinicalpulmonaryinfectionscore(CPIS)- Temperature(ºC) ≥36.5and≤38.4=0point            ≥38.5and≤38.9=1point ≥39or≤36=2points Bloodleukocytecount(cells/mm3) ≥4,000and≤11,000=0point <4,000or>11,000=1point+bandforms ≥500=+1point Trachealsecretions Scanty=0point Moderate/profusebutnotpurulent=1point Moderate/profuseandpurulent=2point Oxygenation:PaO2/FiO2 >240orARDS=0point ≤240andnoevidenceofARDS=2points Pulmonaryradiography Noinfiltrate=0point Patchy/diffuseinfiltrates=1point Localisedinfiltrate=2points             Culture of tracheal aspirate (semi-quantitative) Pathogenic bacteria cultured ≤ 1+ or nogrowth=0point Pathogenicbacteriacultured>1+ornogrowth=1point SamepathogenicbacteriaseenonGramstain>1+=2points Totalscore=CPIS(possiblerange=0to12) Methods: Respiratory physiotherapy procedures assists to expand lung volumes, enhance gas diffusion,reduce work of breathing, reduce MV stay of patients and induce optimum recovery.Inthis the respiratory physiotherapy applications involved a regimen of Positioning, Manual Hyperinflation (MH), Airway Suctioning,PNF for Respiration, Passive Limb Movement protocol and Early Mobilisation protocol. Results: The results shows that the Chronic Pulmonary Infection Score (CPIS) reduced from at the time of admission to at the time of discharge, the significance of P<.005 Conclusion: Respiratory physiotherapy managed Chronic Pulmonary Infection Score (CPIS) reduction from at the time of admission to at the time of discharge and improved the outcome of the ABI patients.
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