摘要
目的探讨机械辅助排痰在婴幼儿重症肺炎机械通气中的气道护理效果。方法采用随机数字表法将入选患儿随机分为2组。治疗组30例,对照组30例。对照组进行常规抗感染、化痰等综合治疗,给予翻身、叩背、体位引流等常规护理。治疗组将对照组治疗护理方案中的人工叩背改为机械振动排痰,每天3次,每次10min。观察2组患儿排痰前后的血气分析结果;治疗后第3天、第6天、第10天胸部X线摄片结果;每天肺部听诊情况。结果机械振动排痰与人工叩背方法相比,在排痰后2组血气分析各项指标、胸部X线提示好转所需时间、肺部听诊症状改善所需时间、机械通气时间的比较差异有统计学意义(P<0.01)。结论机械振动排痰可促进重症肺炎机械通气患儿肺内分泌物的排出,从而改善患儿肺部通气,使得PaO2升高,PaCO2降低,加快肺部炎症的吸收,缩短患儿机械通气时间。
Objective Explore airway nursing effects of mechanical vibration assisted expectoration of airway mechanical ventilation in infants with severe pneumonia. Methods Using the random number table method randomly divided selected infants into two groups. Both treatment group and control group were 30 cases.Control group were given conventional treatment,such as anti-infection, eliminating phlegm,and routine care such as emancipated,knock back,postural drainage. Treatment group were given the same treatment as control group,but turned the artificial knock back to mechanical vibration,3 times per day,every time last for 10 minutes. Observed following oindex：blood gas analysis pre-expectoration and post-expectoration;chest X-ray radiography results post- treament for day 1,day 6,day 10;lung auscultation results each day. Results The differences of indicators of blood gas analysis after the expectoration,signs reduce time needed on chest X-ray,symptoms improve needed time of lung auscultation,and the duration of mechanical ventilation in the two groups have statistical significance（P〈0.01）. Conclusions Mechanical vibration expectoration promote the discharge of intrapulmonary secretions in severe pneumonia infants with mechanical ventilation,and improve lung ventilation,making PaO2 increased and PaC02 decreased,accelerate the absorption of lung inflammation,and shorten the duration of mechanical ventilation.
