摘要
目的探讨纤维支气管镜(FB)吸痰结合浅部吸痰方式对ICU人工气道患者护理效果。方法抽取2017年4月至2018年12月入住江南大学附属医院ICU并建立人工气道行机械通气辅助治疗的患者86例进行回顾性研究,按照吸痰护理方案不同分为两组,行FB吸痰与浅部吸痰相结合的吸痰护理管理患者为研究组,行常规吸痰护理管理患者为对照组,比较两组患者第1、7天动脉血气指标及呼吸力学指标,以及患者气道黏膜损伤、肺部感染的发生率。结果建立人工气道第1天,两组患者P动脉血气指标及呼吸力学指标差异均无统计学意义(P>0.05);建立人工气道第7天研究组患者PaO2与SaO2以及气道峰压显著升高,PaCO2与气道平台压、平均气道压、吸气阻力显著降低,且改善程度均优于对照组(均P<0.05)。研究组发生气道黏膜损伤与肺部感染发生率(16.27%、18.60%)均显著低于对照组(67.44%、46.51%)(均P<0.05)。结论采用FB吸痰结合浅部吸痰护理方案对ICU人工气道患者进行干预可提升呼吸道管理质量,有效改善患者呼吸功能,减少气道黏膜损伤与肺部感染发生率,具有较高的临床应用价值。
Objective To compare the effects of fiber bronchoscope(FB)suctioning with superficial suctioning and traditional airway management in patients with artificial airway in ICU.Method Eight-six patients admitted to the ICU of the Affiliated Hospital of Jiangnan University from April 2017 to December 2018 were selected randomly with artificial airway assisted mechanical ventilation being established.They were divided into 2 groups according to different plans of sputum suction.The integration of FB and superficial suction was performed in research group.And the routine sputum-suction nursing manager was performed in control group.The indexes of arterial blood gas and respiratory mechanics of the artificial airway patients on day 1 and 7 were analyzed.And the incidences of injuries and lung infections were recorded.Results There was no significant difference in blood arterial blood gas index and respiratory mechanics index between the two groups of patients on the 1st day after the establishment of artificial airway(P>0.05).However,PaO2 and SaO2 and PIP increased significantly,and PaCO2,Pplat,mPaw,and Raw decreased were significantly on the 7th day after the construction of artificial airway in study group(P<0.05).The incidences of airway mucosal injury and lung infection(16.27%,18.60%)in the study group were significantly lower than those in the control group(67.44%,46.51%),P<0.05.Conclusions Intervention of FB suctioning and superficial suctioning treatment in ICU patients with artificial airways can improve the quality of airway management and patients'respiratory function effectively,which has high value of clinical practice.
作者
金霞
周春香
JIN Xia;ZHOU Chunxiang(ICU,Affiliated Hospital of Jiangnan University/Wuxi Fourth People's Hospital,Wuxi 214000,China)
出处
《医药高职教育与现代护理》
2020年第3期204-207,共4页
Medical Higher Vocational Education and Modern Nursing
基金
江南大学附属医院院内科研项目(FYHL201802)。
关键词
ICU
人工气道
常规吸痰
纤维支气管镜
浅部吸痰
护理效果
ICU
Artificial airway
Conventional sputum suction
Fiber bronchoscope
Superficial sputum suction
Nursing efficacy
