摘要
目的观察简易呼吸器结合呼吸功能训练在脑卒中气管切开患者气道管理中的应用效果。 方法选择2017年5月至2018年4月在康复科住院脑卒中气管切开患者93例,按入院顺序及随机数字表法随机分成干预组45例和对照组48例。对照组患者在气管切开后进行常规护理,干预组在对照组的基础上进行简易呼吸器结合呼吸功能训练。观察2组患者留置气管套管期间肺部感染发生情况,气管套管总留置时间;拔管24~48 h患者血氧饱和度<0.94发生率,再次置管例数,肺部感染发生情况。 结果干预组和对照组留置套管期间肺部感染发生率比较,干预组的肺部感染率为6.67%(3/45),低于对照组肺部感染率为20.83%(10/48),差异有统计学意义(χ^2=3.89,P=0.04);干预组的气管套管总留置时间为(25.73 ± 6.51)d,短于对照组为(28.28 ± 4.79)d,差异有统计学意义(t=-2.16,P=0.03);在干预组和对照组套管拔出24~48 h,干预组的血氧饱和度<0.94发生率为6.67%(3/45)、肺部感染发生率为2.22%(1/45),再次置管发生率0,均低于对照组的22.92%(11/48)、14.58%(7/48)、10.42%(5/48),差异有统计学意义(χ^2=4.80、4.51、4.75,P=0.03、0.03、0.03)。 结论简易呼吸器结合呼吸功能训练能有效改善患者的呼吸功能,降低气管套管留置期间及套管拔除后肺部感染和再次置管的发生率,缩短了气管套管的留置时间,从而减轻患者的痛苦和经济负担,降低了护理的风险,是科学有效的气道管理措施,值得在临床中推广应用。
Objective To observe the application effect of simple respirator combined with respiratory function training in airway management of patients with cerebral apoplexy after tracheotomy.Methods Totally 93 patients with stroke tracheotomy from May 2017 to April 2018 were randomly divided into the intervention group (45 cases) and thecontrol group (48 cases). The control group was treated with routine nursing after tracheotomy, and the intervention group was trained by simple ventilator combined with breathing function on the basis of the control group.The incidence of pulmonary infection during the tracheal cannula in two groups was observed, the total retention time of the trachea cannula, the incidence of blood oxygen saturation < 94% from 24 h to 48 h, the number of cases of catheterization, and the incidence of pulmonary infection were observed.Results In the intervention group and the control group, the pulmonary infection rate was 6.67% (3/45) in the intervention group, which was lower than the control group. The lung infection rate was 20.83% (10/48). The significance of learning (χ^2=3.89, P=0.04);the total indwelling time of tracheal intubation in the intervention group (25.73±6.51) d was shorter than that in the control group (28.28±4.79) d, the difference was statistically significant (t=-2.16, P=0.03);within the intervention group and the control group, within 24-48 hours, the oxygen saturation of the intervention group was <0.94 (6.6% (3/45), and the incidence of pulmonary infection was 2.22% (1/45). The incidence rate of re-intubation was 0 (0/45), which was lower than 22.92% (11/48), 14.58% (7/48), and 10.42% (5/48) of the control group. The difference was statistically significant (χ^2= 4.80, 4.51, 4.75, P= 0.03, 0.03, 0.03). ConclusionsThe simple breathing apparatus combined with respiratory function training can effectively improve the respiratory function of the patients, reduce the occurrence of pulmonary infection and re tube after the tracheal tubing and tubing, shorten the retention time of the trachea cannula, reduce the patient's pain and economic burden, and reduce the risk of nursing. It is scientific and effective. Airway management measures should be widely applied in clinical practice.
作者
李宁
马飞飞
孙洁
李笑
Li Ning;Ma feifei;Sun Jie;Li Xiao(Department of Rehabilitation,Xuzhou Central Hospital,the Affiliated Xuzhou Hospital of Medical College of Southeast University,Xuzhou Clinical School of Xuzhou Medical University,Xuzhou 221000,China)
出处
《中国实用护理杂志》
2019年第7期540-543,共4页
Chinese Journal of Practical Nursing
关键词
卒中
护理
气管切开
简易呼吸器
呼吸功能训练
Stroke
Tracheotomy
Simple respirator
Respiratory function training
Nursing care
