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长期机械通气患者应用发音气管切开导管的效果研究 被引量:8

The effectiveness of self-designed speaking cuffed tracheostomy tube in patients following long-term mechanical ventilation
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摘要 目的探讨长期机械通气患者应用自制发音气管切开导管的效果。方法将急性生理和慢性健康评分Ⅱ(APACHEⅡ)<15分、意识清楚、气管插管机械通气时间超过1周,需气管切开继续机械通气的呼吸衰竭患者,按随机数字表分为试验组和对照组。试验组选用自制发音气管切开导管,对照组选用普通气管切开导管。全部病例均进行机械通气、标准营养支持等综合治疗。观察两组患者置入气管切开导管前、后1周Zung氏抑郁自评量表(SDS)评分、血清白蛋白、前臂周长变化,同时监测呼吸机相关性肺炎发生率。结果试验组术前术后组内比较Zung评分(t=5.57,P<0.01)、血清白蛋白(t=-3.43,P<0.01)及前臂周长(t=-3.44,P<0.01)的差异均有统计学意义;对照组术前术后组内比较Zung评分差异有统计学意义(t=-4.48,P<0.01),血清白蛋白(t=1.76,P>0.05)及前臂周长差异无统计学意义(t=2.02,P>0.05);两组患者气管切开术后1周呼吸机相关性肺炎发生率比较,差异有统计学意义(χ2=4.84,P<0.05)。结论应用自制发音气管切开导管可以改善患者抑郁状况和生理营养指标,降低呼吸机相关性肺炎发生率,更体现人性化的医疗护理服务。 Objective To evaluate the effectiveness of self-designed speaking cuffed tracheostomy tube in patients following long-term mechanical ventilation. Methods Forty-two respiratory failure patients with mechanical ventilation for more than one week were randomly assigned to speaking cuffed tracheostomy tube group and ordinary cuffed tracheostomy tube group. Comprehensive strategies such as mechanical ventilation and nutritional support were provided for both groups. The score of Zung's self-rating depression scale (SDS),level of serum albumin,changes in forearm circumference,as well as the incidence of ventilator-associated pneumonia (VSP) were monitored one week before and after tracheal intubation. Results After the treatment, the score of SDS was significantly reduced in the experimental group (P0.01),while increased in the control group (P0.01); The level of serum albumin and forearm circumference were significantly increased in the experimental group(P0.01 respective), while no significant difference in the control group. The incidence of VAP in the experimental group was significantly lower than that of the control group one week after tracheal intubation (P0.05). Conclusion Application of self-designed speaking cuffed tracheotomy tube in patients following long-term mechanical ventilation can relieve patients' depression,improve the nutritional status and reduce the incidence of ventilator-associated pneumonia,which can well embody humanistic medical care service.
出处 《中华护理杂志》 CSCD 北大核心 2010年第3期222-224,共3页 Chinese Journal of Nursing
基金 浙江省医药卫生成果重点推广项目(编号:2008TG009)
关键词 气管切开术 通气机 机械 护理 Tracheotomy Ventilators Mechanical Nursing Care
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