RESUMO
Objective:To determine the value of lung function, cannula diameter and swallowing function in predicting the success of tube blocking in patients with severe neurological diseases so as to standardize the tracheal decannulation procedure.Methods:The tracheotomy tube blocking of 28 neurological disease patients was studied retrospectively. Before their tracheotomy tubes were blocked the patients′ lung function and swallowing function had been evaluated, and sputum volume and endotracheal tube diameter had been recorded.Results:The five most useful predictors of success in tracheotomy tube blocking were FVC, FVC%, FEV1 (L), FEV1 (L), FEV1 (L) and PEF(L/S). Their OR values were all greater than 1, indicating good predictive power. FEV1 and PEF showed the best predictive power, with OR values of 81.70 and 27.77, respectively. There was no significant difference between the two groups in terms of the other indicators. FEV1 predicted that the best truncation value for tracheotomy tube blocking success is 0.42L, achieving a sensitivity was 100% a specificity of 63.64%, and a correction index of 0.636.Conclusion:FEV1 values can be a useful predictor of successful tracheotomy tube blocking. Using it should improve the success rate of tube decannulation.
RESUMO
Objective To observe the effect of aerobic exercise combined with impedance training on the blood pressure variability and other blood-related indexes of patients with hypertension. Methods Ninety patients with essential hypertension were randomly divided into group A, group B and group C, each of 30. All were treated with conventional anti-hypertensive drugs. Groups B and C additionally underwent 40 minutes of aerobic training and group C also received resistance training. There were 3 training sessions a week for 12 weeks. Each subject's 24 h systolic blood pressure (24hSBP), 24 h diastolic blood pressure (24hDBP) and their standard deviations were ob-served before and after the 12 weeks. Blood indexes were examined and a plasma arteriosclerosis index was calculated. Results Before the treatment, there were no significant differences in any of the average measurements among the three groups. After the treatment, the average 24hSBP and 24hDBP of all three groups had decreased significantly, but larger decreases were observed in groups B and C. Compared with group B, the average 24hSBP and 24hDBP of group C had decreased significantly more. The average levels of atherogenic index of plasma ( AIP) and lipoprotein phospholipase A2 of groups B and C were significantly lower than before the treatment and also significantly lower than group A's average. The decrease in group C was significantly greater than in group B. Conclusions Anti-hyperten-sive drugs can lower blood pressure, but cannot effectively control blood pressure variation, reduce blood lipids or im-prove the arteriosclerosis index. Long-term, regular aerobic exercise can decrease these indicators and reduce cardio-vascular disease risk in elderly patients with hypertension. Aerobic exercise combined with mild to moderate circulato-ry resistance exercise is more effective than aerobic exercise alone.