气道灌洗在气管切开患者中的应用与效果评价.DOC

2016-05-06 魏编辑加工完成 2016-10-11 董 2016-10-2 董返魏，魏送贾 适度液体刺激在气管切开中的效果评价 郭亚辉，刘亚红，李 婷，吴建青，朱小敏 (南京军区南京总医院神经内科，江苏 南京 210002) [摘要]目的：探讨气道液体刺激在气管切开患者气道护理中的可行性及应用效果。方法：将90例气管切开患者随机分为试验1组、试验2组和对照组，每组30例，均进行常规气道护理。试验1组用20 mL注射器将0.45%NaCl快速注入人工气道，试验2组用灭菌注射用水快速注入人工气道，进行气道灌洗，对照组则采用常规吸痰。结果：⑴试验组患者排痰效果优于对照组患者（P＜0.05）；⑵试验组患者痰液黏稠度低于对照组患者（P＜0.05）；⑶3组的血气分析pH值、PaO2、SaO2及心率、呼吸频率、血压等无显著差异（均P＞0.05）。结论：在气管切开患者护理中，气道适度的液体刺激能有效降低患者痰液黏稠度、痰痂形成及堵管的发生，优于单纯的吸痰和持续气道湿化法。 [关键词]液体刺激；气道灌洗；气管切开；气道湿化；效果评价 [中图分类号]R473.74 [文献标识码]B DOI:10.11851/j.issn.1673-1557.2016.06.0 Evaluation of Moderate Liquid Stimulation in Tracheotomy GUO Yahui, LIU Yahong, LI Ting, WU Jianqing, ZHU Xiaomin (Department of Neurology, Nanjing General Hospital of Nanjing Military Command, Nanjing, Jiangsu 210002, China) [Abstract] Objective: To investigate the feasibility and efficacy of airway liquid stimulation in tracheotomy. Methods: 90 tracheotomy patients were randomly divided into experimental group 1, experimental group 2 and control group, 30 cases in each group. They all received routine airway nursing. 0.45% saline of 20 mL was rapidly injected into artificial airway for airway lavage in experimental group 1 while sterile water for injection was rapidly injected into artificial airway in experimental group 2; conventional sputum suction was applied in the control group. Results: Both experimental groups showed better efficacy of sputum elimination and lower sputum sticky than the control group （P＜0.05). There were no significant differences in pH value, PaO2,SaO2,HR,RR and BP among the three groups(P＞0.05）. Conclusion: In the nurse of tracheotomy patients, moderate liquid stimulation can reduce sputum sticky , the formation of sputum scab and the occurrence of tube blockage. It is superior to simple sputum suction and continuous airway humidification. [Keywords] liquid stimulation; airway lavage; tracheotomy; airway humidification; efficacy evaluation 呼吸道黏液-纤毛系统是呼吸道的第一道防线，对于维持呼吸道湿化及正常的防御功能具有重要作用。正常呼吸过程中，干燥、低温的空气流经上呼吸道