摘要
目的探讨30°和45°角度在腹部术后患者机械通气撤机至拔管时间和舒适度中的影响。方法选取2018年1—11月于东部战区总医院普通外科研究所SICU收治的经口气管插管的腹部术后患者共64例为研究对象。采取随机数字表法分为A组31例与B组33例,研究过程中A组1例,B组3例撤机过程中出现呼吸困难终止治疗。最终选取A组30例,B组30例患者。A组治疗期间抬高床头角度为30°,B组治疗期间抬高床头角度为45°。2组在撤机期间均使用床头角度卡测量床头高度。比较2组患者撤机期间舒适度(改良版的视觉模拟评分法评分)、撤机至拔管时间、误吸率、插管时间、压疮率、拔管后肺功能及血流动力学变化等指标。结果患者撤机至拔管时间、撤机期间氧合指数、撤机期间舒适度评分A组分别为117.50(45.25,189.00)min、348.20±59.72 mmHg(1 mmHg=0.133 kPa)、1.00(1.00,2.00)分,B组分别为30.00(13.50,42.75)min、314.60±67.13 mmHg(1 mmHg=0.133 kPa)、3.00(2.00,3.00)分,2组比较差异有统计学意义(Z值为-2.411、-4.806,t值为2.048,P<0.05或0.01)。结论腹部术后患者机械通气撤机期间床头抬高30°能够缩短患者撤机至拔管的时间,提高患者的氧合指数,改善患者撤机期间舒适度,可作为腹部术后患者早期撤机辅助干预措施之一。
Objective To explore the effects of 30°and 45°angles on the time and comfort of mechanical ventilation and extubation for patients undergoing abdominal surgery.Methods A total of 64 patients who underwent oral tracheal intubation at SICU in the General Surgery Center of the Critical Care Medical Center of our hospital from January 2018 to November 2018 were selected.A total of 64 patients were randomly divided into group A and group B by random number table method,of which there were 31 people in group A and 33 people in group B.During the experiment,1 people in group A and 3 people in group B experienced dyspnea during the withdrawal process and terminated treatment.Finally,30 patients in group A and 30 patients in group B were selected.The bedside angle during group A treatment was 30°,and the bedside angle during group B treatment was 45°.The bedside angle card was used by both groups to measure the height of the bedside during the weaning.The two groups of patients were compared during the weaning period(improved Visual Analogue Scale score),weaning to extubation time,aspiration rate,intubation time,pressure ulcer rate,pulmonary function and hemodynamic changes after extubation.Results Patients with ventilator to extubation time,during the machine during oxygenation index,pulled machine comfort score in group A were 117.50(45.25,189.00)min,(348.20±59.72)mmHg(1 mmHg=0.133 kPa),1.00(1.00,2.00)points,group B were respectively 30.00(13.50,42.75)min,(314.60±67.13)mmHg and 3.00(2.00,3.00)points,two groups comparing the difference was statistically significant(Z values was-2.411,-4.806,t value was 2.048,P<0.05 or 0.01).Conclusion Lifting the bedside 30°during mechanical ventilation withdrawal in patients with abdominal surgery can shorten the time from patient withdrawal to extubation,improve the patient's oxygenation index,and improve the comfort during patient withdrawal.It can be used as an early patient for abdominal surgery.One of the auxiliary intervention measures for withdrawal.
作者
江萍
顾璐璐
吴翠丽
叶向红
高涛
Jiang Ping;Gu Lulu;Wu Cuili;Ye Xianghong;Gao Tao(SICU of General Surgery,Eastern Theater General Hospital,Nanjing 210000,China)
出处
《中国实用护理杂志》
2020年第32期2501-2505,共5页
Chinese Journal of Practical Nursing
关键词
机械通气
撤机
床头角度
护理
Mechanical ventilation
Withdrawal
Bedside angle
Nursing care
