加温湿化器联合密闭式吸痰对人工气道管理效果的研究

发布时间：2018-02-14 19:26

本文关键词： 人工气道加温湿化器密闭式吸痰气道管理湿化　出处：《吉林大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：探讨加温湿化器联合密闭式吸痰对人工气道患者的护理效果，为形成系统的、科学的气道管理规范提供依据。方法：本研究选取2013年12月-2014年7月吉林大学第一医院神经外科ICU102例置入人工气道的患者，按随机方法分为试验组（加温湿化器联合密闭式吸痰组）49例和对照组（人工鼻联合一次性吸痰组）53例，两组患者均接受其它日常常规护理，所有操作由神经外科ICU接受过统一培训的责任护士完成。对两组患者的痰液黏稠度、湿化效果、痰痂发生率、肺部感染发生率、痰细菌培养阳性率、痰培养阳性菌株次数、人工气道留置时间及ICU住院时间进行比较。全部数据采用SPSS17.0软件和Excel表格进行统计分析，计量资料采用t检验，计数资料采用χ2检验，等级资料采用秩和检验，P0.05为差异有统计学意义。结果： 1.两组患者痰液黏稠度在第五天（P0.05）和第七天（P0.05）观察组均比对照组稀薄。 2.两组平均血氧饱和度在第三天、第五天和第七天比较均无统计学差异（P＞0.05）。 3.试验组患者未形成痰痂，有3例（6.1%）患者发生肺部感染，对照组有7例（13.2%）患者形成痰痂，有12例（22.6%）患者发生肺部感染，两组比较，试验组痰痂发生率（P0.05）和肺部感染发生率（P0.05）均低于对照组。 4.试验组呼吸道细菌培养阳性例数较对照组少，，差别有统计学意义（P0.05）;两组的痰培养菌株种类差别无统计学意义（P0.05）。 5.试验组人工气道留置时间为（7.51±2.38）d, NSICU住院时间为（12.49±3.19）d，对照组人工气道留置时间为（10.47±3.37）d，NSICU住院时间为（13.94±2.48）d，两组比较，试验组人工气道留置时间（P 0.05）及NSICU住院时间（P 0.05）均少于对照组。结论： 1.两种气道护理方法中，加温湿化器联合密闭式吸痰法气道湿化效果更佳，但与人工鼻联合一次性吸痰法在维持SPO2稳定性方面无明显差异。 2.加温湿化器联合密闭式吸痰法可以更好地减低痰液粘稠度，具有长期临床效果。 3.加温湿化器联合密闭式吸痰法可明显降低肺部感染发生率，且在研究期间未发生痰痂，对促进患者疾病康复具有积极影响。 4.加温湿化器联合密闭式吸痰法可以减少呼吸道内细菌的定植。 5．加温湿化器联合密闭式吸痰法产生良好的气道护理效果，缩短人工气道留置时间和ICU住院时间，有利于患者及早出院，对促进床位周转和提高医院的社会效应产生积极影响。
[Abstract]:Objective:. To explore the nursing effect of humidifier combined with closed suction on patients with artificial airway and provide basis for systematic and scientific airway management. Methods:. From December 2013 to July 2014, we selected ICU102 patients who were placed in artificial airway in the first Hospital of Jilin University. According to the random method, the patients were divided into the experimental group (49 cases in the hyperthermia humidifier combined with closed suction group) and the control group (53 cases in the artificial nose combined with one-off aspiration group). The patients in both groups received other routine nursing care. All operations were performed by the nurses responsible for the unified training of ICU in neurosurgery. The sputum viscosity, humidification effect, sputum eschar rate, pulmonary infection rate, sputum bacterial culture positive rate, sputum culture positive strains, sputum culture positive rate, sputum culture positive rate, sputum culture positive rate, sputum culture positive rate, The retention time of artificial airway and the hospitalization time of ICU were compared. All the data were statistically analyzed by SPSS17.0 software and Excel table, the measurement data were analyzed by t test, and the count data were analyzed by 蠂 2 test. Grade data using rank sum test (P 0.05) was statistically significant. Results:. 1. The viscosity of sputum in the two groups was thinner than that in the control group at day 5th (P 0.05) and day 7th (P 0.05). 2. There was no significant difference in the mean oxygen saturation between the two groups on the third day, 5th days and 7th days (P > 0.05). 3. In the test group, sputum scab was not formed, there were 3 patients with sputum infection, 7 patients in the control group developed sputum scab, 12 patients in the control group developed sputum scab, and 12 patients developed pulmonary infection. The incidence of sputum scab and pulmonary infection in the test group was lower than that in the control group. 4. The number of positive cases of respiratory tract bacteria in the test group was less than that in the control group, and the difference was statistically significant (P 0.05), and there was no significant difference between the two groups in sputum culture strains. 5. The retention time of artificial airway and NSICU were 7.51 卤2.38 and 12.49 卤3.19 days in the experimental group and 10.47 卤3.37 days in the control group, respectively. Compared with the control group, the retention time of artificial airway in the trial group was less than that in the control group (P 0.05) and NSICU (P 0.05). Conclusion:. 1. In the two kinds of airway nursing methods, the humidifier combined with closed suction has better effect on airway humidification, but there is no significant difference between the two methods in maintaining the stability of SPO2. 2. The temperature humidifier combined with closed sputum suction can reduce the mucus viscosity of sputum better and has long-term clinical effect. 3. Warming and humidifying apparatus combined with closed sputum suction can significantly reduce the incidence of pulmonary infection, and no sputum scab occurred during the study period, which has a positive effect on promoting the rehabilitation of patients. 4. Warming humidifier combined with closed sputum suction can reduce bacterial colonization in respiratory tract. 5. Warming humidifier combined with closed sputum suction had good effect on airway nursing, shortening the time of artificial airway indwelling and ICU hospitalization, which was beneficial to the early discharge of patients and had a positive effect on promoting bed turnover and improving the social effect of hospital.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R472

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