新生儿机械通气撤机成功影响因素临床观察与护理.docVIP

新生儿机械通气撤机成功影响因素临床观察与护理 　　【摘要】 目的:探讨新生儿机械通气撤机成功的影响因素并提供有针对性地护理方案。方法:观察59例新生儿机械通气撤机前的生命体征、生化指标及有无并发症。撤机后连续观察48h，无需再次应用呼吸机者为撤机成功，需要重新应用呼吸机者为撤机失败。结果:59例患儿共完成68次撤机，49次撤机成功，19次撤机失败，失败率为27.9%。早产低体重、肺部感染、败血症、出生时Apgar评分是影响撤机成功的因素。撤机失败组与撤机成功组比较，体重、Apgar评分、肺部感染及败血症发生率差异有统计学意义（p ＜0.05）。结论:针对Apgar评分高的低体重新生儿，积极有效的护理能防止肺部感染及败血症的发生，能有效提高撤机成功率。 　　【关键词】机械通气；撤机；新生儿；护理 　　The Clinical Observation and Nursing of Influence Factors to the Successful Respirator-withdrawal in New Arrivals mechanical Ventilation 　　DengJunXiaoXiaoMei 　　【Abstract】 Objective: Discuss the influence factors of a successful respirator-withdrawal in new arrivals mechanical ventilation and provide the nursing programs pointedly. Methods: Observe the 59 new arrivals body symptom, bio-chemical parameters, and having complication disease or not before withdrawing respirators when in mechanical ventilation. After withdrawing respirators, observe for 48 hours continually, if there is no need to use respirators once more, the respirator-withdrawal is successful, if they need to use the respirators again, the respirator- withdrawal is failure. Result: There are altogether 68 respirator-withdrawals in these 59 sick new arrivals. Among them, 49 respirator-withdrawals are successful, while 19 respirator-withdrawals are not; the failure rate is 27.9%. The factors to influence the successful respirator-withdrawals or not are: the lower body weight in premature birth, lung infection, septicemia, and the Apgar scores at birth. When comparing the respirator-withdrawal failure group with the successful group, the body weight, Apgar scores, lung infection, and the difference of septicemia incidence are of statistical significance(p 本文为全文原貌 未安装PDF浏览器用户请先下载安装 原版全文 　　2 结果 　　59例患儿共完成68次撤机，其中19次撤机失败，失败率27.9%。两组患儿的临床观察指标见表1。结果显示撤机失败组体重低、Apgar评分高、肺部感染、败血症等发生率高，与撤机成功组比较差异有统计学意义（p＜0.05）。 　　3 护理 　　3.1 防止肺部感染的护理: 　　3.1.1 肺部感染是影响撤机成功与否的独立危险因素。本组研究显示撤机失败组肺部感染发生率为84.2%（16/19），撤机成功组肺部感染发生率为42.3%（21/49），两者差异有统计学意义（p=0.002）。机械