高频胸壁振荡与传统翻身拍背对卒中卧床患者肺部分泌物清除及误吸预防的对比研究

A Comparative Study on High-Frequency Chest Wall Oscillation and Traditional Turning and Back Tapping in the Clearance of Pulmonary Secretions and Prevention of Aspiration in Bedridden Stroke Patients

摘要: 目的：探讨高频胸壁振荡在卒中卧床患者肺部分泌物清除及误吸预防中的临床应用效果。方法：选取2022年1月至2026年1月我院收治的卒中卧床患者100例，采用随机数字表法分为观察组和对照组各50例。对照组实施传统翻身拍背排痰护理，观察组采用高频胸壁振荡技术进行排痰干预，两组均给予卒中常规治疗与基础护理。比较两组患者肺部感染控制时间、日均排痰量、血氧饱和度改善情况及误吸性肺炎发生率，同时记录两组不良反应发生情况。结果：观察组日均排痰量显著高于对照组，血氧饱和度改善幅度更大，肺部感染控制时间明显短于对照组，差异均有统计学意义(P < 0.05)；观察组误吸性肺炎发生率显著低于对照组，差异有统计学意义(P < 0.05)；两组不良反应发生率比较，差异无统计学意义(P > 0.05)。结论：高频胸壁振荡能更高效地促进卒中卧床患者肺部分泌物排出，改善肺通气功能，有效降低误吸性肺炎发生风险，排痰效果优于传统翻身拍背，且安全性良好，可作为卒中卧床患者呼吸道管理的优选干预手段。

Abstract: Objective: To explore the clinical application effect of high-frequency chest wall oscillation in the clearance of pulmonary secretions and prevention of aspiration in bedridden stroke patients. Methods: A total of 100 bedridden stroke patients admitted to our hospital from January 2022 to January 2026 were selected and divided into an observation group and a control group, each consisting of 50 cases, using a random number table method. The control group received conventional turning, back tapping, and expectoration nursing, while the observation group was intervened with high-frequency chest wall oscillation technology for expectoration. Both groups received routine stroke treatment and basic nursing. The pulmonary infection control time, daily sputum volume, improvement of oxygen saturation, incidence of aspiration pneumonia, and adverse reaction occurrence in both groups were compared. The observation group had a significantly higher daily sputum volume than the control group, a greater improvement in oxygen saturation, and a significantly shorter time to control pulmonary infection compared with the control group, with statistical significance (P < 0.05); the incidence of aspiration pneumonia in the observation group was significantly lower than that in the control group, with statistical significance (P < 0.05); there was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: High-frequency chest wall oscillation can more effectively promote the expulsion of pulmonary secretions in bedridden stroke patients, improve pulmonary ventilation function, effectively reduce the risk of aspiration pneumonia, and has better sputum clearance effects than traditional turning and back tapping, with good safety. It can be used as the preferred intervention for respiratory management in bedridden stroke patients.