摘要
目的 探讨吸痰顺序对人工气道机械通气患者吸痰效果的影响.方法 选取2016年1月—2017年4月在哈尔滨医科大学附属第一医院接受机械通气支持的患者92例,依据随机数表分为观察组（46例）和对照组（46例）,观察组吸痰顺序为先口鼻腔、后气管;对照组吸痰顺序为先气管、后口鼻腔.比较两组护士工作量、吸痰效果、SaO2、PaCO2、黏膜损伤和VAP发生率.结果 观察组的吸痰时间、吸痰次数、机械通气时间和住院时间均低于对照组,吸痰间隔时间、吸痰舒适度高于对照组,差异有统计学意义（P〈0.05）.吸痰前,两组患者的SaO2、PaCO2差异无统计学意义（P〉0.05）;吸痰后,观察组患者的SaO2高于对照组,PaCO2低于对照组,差异有统计学意义（P〈0.05）.观察组的黏膜损伤、VAP发生率分别为8.70%、6.52%,对照组为17.39%、23.91%,差异有统计学意义（P〈0.05）.结论 先口鼻腔后气管插管内吸痰能够有效降低VAP发生风险,减轻护士工作负担,提高吸痰舒适度,值得临床推广.
Objective To investigate the effect of suctioning order on suctioning in patients with artificial airway ventilation.Methods A total of 92 patients with mechanical ventilator in the First Affiliated Hospital of Harbin Medical University who were recruited from January 2016 to April 2015 were divided into observation group （n=46） and control group （n=46） by random number table method. The suction order for patients in the observation group was from oral nasal cavity to trachea,while the order was adverse in the control group. Nurse workload,suction effect,SaO2,PaCO2,mucosal injury and ventilator associated pneumonia incidence of two groups were compared.Results The time of suction,duration of suction and ventilation,as well as hospital stays of observation group were less than those of the control group （P〈0.05）. Before suction,there was no difference in SaO2 and PaCO2 between the two groups （P〉0.05）. After suction,the SaO2 of the observation group was higher than that of the control group,PaCO2 was lower than that of the control group（P〈0.05）. The incidence of mucosal injury and ventilator-associated pneumonia in the experimental group were 8.70%,6.52% compared with 17.39% and 23.91% in the control group （P〈0.05）.Conclusions Suction with order from oral and nasal cavity to trachea can effectively reduce the risk of ventilator associated pneumonia,reduce the workload of nurses,improve patients′ comfort while suctioning,it is worth for clinical promotion.
出处
《中华现代护理杂志》
2017年第32期4118-4121,共4页
Chinese Journal of Modern Nursing
基金
黑龙江省护理学会“威高天使”护理科研基金
关键词
呼吸
人工
肺炎
呼吸机相关性
吸痰
顺序
黏膜损伤
舒适度
Respiration,artificial
Pneumonia,ventilator-ssociated
Suction
Order
Mucosal injury
Comfort
