The Research On Dynamic Changes In CT Manifestations Of Lungs Of Bedridden Patients With Cerebrovascular Disease And The Prevention And Treatment Effect Of Back Patting On Pneumonia

Objective: This thesis aims at reducing pneumonia complications infected by bedridden patients with cerebral vascular disease and identifying and=distinguishing=between=pulmonary hypostatic effect=and=hypostatic pneumonia through dynamic observation of these patients’ CT manifestations and discussion of the occurrence, development, outcome and specificity of CT performance.Method: This thesis takes 60 bedridden patients with cerebral vascular disease hospitalized in our internal medicine department as the object of study. Bases on their mental state of consciousness, these cases are divided into coma group and non-coma group with 30 cases on each group and the exclusion of patients with respiratory muscle paralysis or invasive operation. The non-coma group is then randomly divided into two subgroups- control subgroup and intervention subgroup, each consisting of 15 cases. Conventional nursing measures are adopted to the control subgroup, and back patting intervention is taken in the intervention subgroup. All patients will take conventional low-dose spiral CT examinations on the day of the onset of cerebral vascular disease, the third day, the fifth day, the seventh day, the ninth day. While taking the CT scan, patients will first take the supine position and then take prone position when they are identified or have high probability of hypostatic pneumonia. The interventional subgroup, however, will take the supine position to run conventional low-dose CT scan after they get back patting treatment. Then the imaging features of each group and subgroup in each=stage=will=be=observed=in=order=to=identify=hypostatic phenomenonand hypostatic pneumonia occurring time,location,shape,density,side, peripheral lung lesions=and=pleural effusion change,=and=analyze=the=differences of CT images between the interventional group and other groups.Result: The experiment shows that among the 60 bedridden patients cerebral=vascular=disease=there=are=a total of 42 cases of secondary pneumonia, 47 cases with obviously pulmonary hypostatic effect and 42 cases with identified hypostatic pneumonia. Among the 42 patients with identified hypostatic pneumonia, the first CT scan shows hypostatic effect along the bilateral or unilateral lower chests in 5 cases. The second CT examination for patients with highly suspected lung lesion indicates that 3 cases have small opacity with fuzzy boundary in the inferior section of the lung on both sides and=single=side; another 11 patients=show patchy lesions on one side=of the lung and small flake fuzzy lesions on the other side; large or wedge-shape fuzzy opacities in bilateral or unilateral lower lungs with high density are found in 15 cases. There are 28 cases displaying pleural effusion with varying degree of pleural thickening performance.In=using=time=axis=to=observe=pulmonary hypostatic effect and hypostatic pneumonia, patients show arc-shaped ground glass fuzzy opacity in the hypostasis of the bilateral or unilateral lungs on the day of the onset and the third day after the onset. On the fifth day, visible local patchy fuzzy shadows with high density are found in some patients while some patients have large fuzzy opacity with high density in the hypostasis of the bilateral or unilateral lungs. Consolidation symptoms sometimes include air bronchogram with or without pleural effusion and pleural thickening performance. There are some patients who show patchy or flake-shaped opacity with high density in their chests on the seventh and the ninth day.The non-coma group shows 16 cases of hypostatic pneumonia in 30 patients while the coma group has 26 cases of hypostatic pneumonia in 30 patients.There=exist=significant=difference=in=incidence=rate=of=hypostaticpneumonia between patients of the two groups. P<0.05, and it has statistical significance. Among the 15 patients in the control subgroup, there are 13 cases of hypostatic pneumonia while the interventional subgroup has 3 cases of hypostatic pneumonia out of 15 patients. The data of the two groups are compared and have big difference. P<0.05, and it is statistically significant.Conclusion:=Pulmonary hypostatic effect is the pathological basis for bedridden=patients=with=cerebral vascular disease suffering=from=hypostaticpneumonia. The=dynamic=spiral=CT=examinations conducted during the postoperative=rehabilitation=period=of=the=bedridden=patients=with=cerebral vascular disease can improve the diagnostic capacity for the detection of early hypostatic pneumonia through observation of the hypostatic effect and the specific characteristics of hypostatic pneumonia. Meanwhile, the experiment indicates that the back patting treatment can significantly reduce the incidence of pulmonary hypostasis and have great importance in improving the bedridden patients’ quality of life as well as clinical effect.