摘要
目的探讨不同平面创伤性高位截瘫患者人工气道的类型选择及护理策略。方法回顾性分析2009年10月—2010年10月112例急性颈椎及胸椎创伤致高位截瘫的患者,统计本组患者不同损伤节段伤后1 d气管插管及气管切开的例数及1周后气管插管及气管切开的例数,并探讨护理对策。结果 C4、C5、C6平面损伤患者1周后改为气管切开率分别为100%(12/12)、93%(26/28)、18%(2/11);初次气管切开及气管插管者发生呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)分别为24%(10/41)、54%(38/71),两者比较差异有统计学意义(P<0.05)。结论高位截瘫患者气管插管比气管切开VAP发生率风险较高,对于损伤在C5脊神经及以上水平的患者,宜尽早配合医生行气管切开。
Objective To discuss suitable artificial airway for patients with traumatic high paraplegia and nursing strategy. Methods A retrospective study was conducted among 112 patients with traumatic high paraplegia to collect cases of tracheal intubation and tracheotomy 1 d and 7 d after injury. Results The incidence of tracheotomy of patients who were with C4,C5,C6 segment injuries were 100% （12/12）, 93%（26/28）and 118%（2/11 ）respectively, 7 d after injury. The incidence of ventilator-associated pneumonia （VAP） of patients who received tracheotomy for the first time and those with tracheal intubation were 24%（10/41） and 54% （38/71）, the result of which was statistically significant （P〈0.05）. Conclusion There are more risks in tracheal intubation than in tracheotomy for patients with high paraplegia. Tracheotomy is recommended for patients with injuries in and above C5 spinal level.
出处
《护理学报》
2011年第23期51-52,共2页
Journal of Nursing（China）
关键词
高位截瘫
创伤性
人工气道
呼吸机相关性肺炎
护理
high paraplegia, traumatic
artificial airway
ventilator-associated pneumonia
nursing care
