烧伤合并吸入性损伤患者气管切开术后吸痰方法的比较研究
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摘要
目的:探讨烧伤合并吸入性损伤患者气管切开术后吸痰方法的比较。方法:选取2016年5月-2018年4月本院烧伤合并吸入性损伤气管切开术后患者60例。按照随机数字表法将其分为改良组和常规组,各30例。常规组给予常规吸痰法干预,改良组给予改良吸痰法干预。比较两组吸痰效果、肺通气功能、并发症。结果:改良组肺部湿啰音、痰液黏稠度得分均低于常规组(P<0.05);改良组吸痰总有效率高于常规组(P<0.05);干预后,两组动脉血氧分压、动脉血二氧化碳分压及氧合指数均优于干预前,且改良组均优于常规组,差异均有统计学意义(P<0.05);改良组并发症发生率低于常规组(P<0.05)。结论:改良吸痰法可有效提高烧伤合并吸入性损伤患者气管切开术后吸痰效果,有利于改善患者的肺通气功能,且并发症少,值得临床推广。
Objective:To discuss the comparison of sputum aspiration after tracheotomy in patients with burn and inhalation injury.Method:A total of 60 burn patients with inhalation injury after tracheotomy in our hospital from May 2016 to April 2018 were selected.According to the random number table method,they were divided into improved group and routine group,30 cases in each group.The routine group was given conventional sputum suction intervention,and improved group was given improved sputum suction intervention.The sputum aspiration effect,pulmonary ventilation function and complications between two groups were compared.Result:The scores of lung moist rale and sputum viscosity in improved group were lower than those of routine group(P<0.05).The total effective rate of sputum aspiration in improved group was higher than that of routine group(P<0.05).After intervention,the arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide and oxygenation index of two groups were better than those of before intervention,and the improved group were better than those of routine group,the differences were statistically significant(P<0.05).The incidence of complications in improved group was lower than that of routine group(P<0.05).Conclusion:The improved sputum suction method can effectively improve the sputum suction effect of burn patients with inhalation injury after tracheotomy,and is conducive to improving the pulmonary ventilation function of patients with fewer complications,which is worthy of clinical promotion.
Objective:To discuss the comparison of sputum aspiration after tracheotomy in patients with burn and inhalation injury.Method:A total of 60 burn patients with inhalation injury after tracheotomy in our hospital from May 2016 to April 2018 were selected.According to the random number table method,they were divided into improved group and routine group,30 cases in each group.The routine group was given conventional sputum suction intervention,and improved group was given improved sputum suction intervention.The sputum aspiration effect,pulmonary ventilation function and complications between two groups were compared.Result:The scores of lung moist rale and sputum viscosity in improved group were lower than those of routine group(P<0.05).The total effective rate of sputum aspiration in improved group was higher than that of routine group(P<0.05).After intervention,the arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide and oxygenation index of two groups were better than those of before intervention,and the improved group were better than those of routine group,the differences were statistically significant(P<0.05).The incidence of complications in improved group was lower than that of routine group(P<0.05).Conclusion:The improved sputum suction method can effectively improve the sputum suction effect of burn patients with inhalation injury after tracheotomy,and is conducive to improving the pulmonary ventilation function of patients with fewer complications,which is worthy of clinical promotion.
引文
[1]Veeravagu A,Yoon B C,Jiang B,et al.National trends in burn and inhalation injury in burn patients:results of analysis of the nationwide inpatient sample database[J].J Burn Care Res,2015,36(2):258-265.
[2]You K,Yang H T,Kym D,et al.Inhalation injury in burn patients:establishing the link between diagnosis and prognosis[J].Burns,2014,40(8):1470-1475.
[3]王定坤,金心,吴晔.重度颅脑外伤患者气管切开术后肺部感染分析[J].中华医院感染学杂志,2014,24(5):1212-1214.
[4]程丽,贾蕊霞,王欣,等.两种吸痰法应用于气管切开术后的效果比较[J].山西医药杂志,2015,44(7):802-804.
[5]陈海为,梁朋,苏宁,等.改良吸痰方法在防治机械通气患者呼吸机相关性肺炎的作用观察及影响因素[J].实用临床医药杂志,2015,(14):27-29,42.
[6]Aung M T,Garner D,Pacquola M,et al.The use of a simple three-level bronchoscopic assessment of inhalation injury to predict in-hospital mortality and duration of mechanical ventilation in patients with burns[J].Anaesth Intensive Care,2018,46(1):67-73.
[7]李正碧,朱晓镝,李云琴,等.目标设定结合互动宣教对骨科住院患者肺部感染的预防效果研究[J].中华医院感染学杂志,2017,27(21):5014-5017.
[8]王海波,周伟宏.系列排痰训练治疗脑卒中患者气管切开术后合并肺部感染的疗效观察[J].中国康复,2017,32(6):500-502.
[9]You K,Yang H T,Kym D,et al.Inhalation injury in burn patients:establishing the link between diagnosis and prognosis[J].Burns,2014,40(8):1470-1475.
[10]Spano S,Hanna S,Li Z,et al.Does bronchoscopic evaluation of inhalation injury severity predict outcome?[J].J Burn Care Res,2016,37(1):1-11.
[11]缪素萍,邓瑞文,钟文珍.神经外科气管切开术后下呼吸道感染危险因素的调查分析[J].中华医院感染学杂志,2008,18(5):646-648.
[12]Maxwell B G,Ganaway T,Lighthall G K.Percutaneous tracheostomy at the bedside:13 tips for improving safety and success[J].J Intensive Care Med,2014,29(2):110-115.
[13]张延红,赵晓丽,刘岩,等,白雪.脑卒中患者气管切开术后吸痰方法的临床研究[J].河北医药,2014,36(7):1089-1090.
[14]杨淑梅,关淑芬,吴杨,等.两种吸痰法预防呼吸机相关性肺炎的效果研究[J].中华医院感染学杂志,2016,26(15):3398-3399,3408.
[15]毕娜,王建荣.改良深部吸痰法在重型颅脑损伤气管切开患者中的应用[J].解放军护理杂志,2015,32(12):6-9.
[16]叶向红,江方正,宋湘玲,等.腹腔内高压并存急性呼吸窘迫综合征患者吸痰方法的改进[J].护理学杂志,2016,31(2):66-68.
[17]麦燕华,刘群兰.两种吸痰法在烧伤合并吸入性损伤患者中的应用效果比较[J].齐鲁护理杂志,2017,23(20):111-113.
[18]李树伟,田秀芬.按压胸骨上窝联合浅部吸痰法用于重型颅脑损伤气管切开患者的研究[J].实用临床医药杂志,2015,19(18):10-12.
[19]汤云,黄美霞,雍海荣.探讨重症患者气管切开术后有效吸痰的方法[J].护士进修杂志,2015,30(20):1907-1908.
[20]林真珠,楚阳,张国英,等.两种吸痰法对气管插管早产儿心率及氧饱和度的影响[J].海南医学,2014,25(5):771-773.
[2]You K,Yang H T,Kym D,et al.Inhalation injury in burn patients:establishing the link between diagnosis and prognosis[J].Burns,2014,40(8):1470-1475.
[3]王定坤,金心,吴晔.重度颅脑外伤患者气管切开术后肺部感染分析[J].中华医院感染学杂志,2014,24(5):1212-1214.
[4]程丽,贾蕊霞,王欣,等.两种吸痰法应用于气管切开术后的效果比较[J].山西医药杂志,2015,44(7):802-804.
[5]陈海为,梁朋,苏宁,等.改良吸痰方法在防治机械通气患者呼吸机相关性肺炎的作用观察及影响因素[J].实用临床医药杂志,2015,(14):27-29,42.
[6]Aung M T,Garner D,Pacquola M,et al.The use of a simple three-level bronchoscopic assessment of inhalation injury to predict in-hospital mortality and duration of mechanical ventilation in patients with burns[J].Anaesth Intensive Care,2018,46(1):67-73.
[7]李正碧,朱晓镝,李云琴,等.目标设定结合互动宣教对骨科住院患者肺部感染的预防效果研究[J].中华医院感染学杂志,2017,27(21):5014-5017.
[8]王海波,周伟宏.系列排痰训练治疗脑卒中患者气管切开术后合并肺部感染的疗效观察[J].中国康复,2017,32(6):500-502.
[9]You K,Yang H T,Kym D,et al.Inhalation injury in burn patients:establishing the link between diagnosis and prognosis[J].Burns,2014,40(8):1470-1475.
[10]Spano S,Hanna S,Li Z,et al.Does bronchoscopic evaluation of inhalation injury severity predict outcome?[J].J Burn Care Res,2016,37(1):1-11.
[11]缪素萍,邓瑞文,钟文珍.神经外科气管切开术后下呼吸道感染危险因素的调查分析[J].中华医院感染学杂志,2008,18(5):646-648.
[12]Maxwell B G,Ganaway T,Lighthall G K.Percutaneous tracheostomy at the bedside:13 tips for improving safety and success[J].J Intensive Care Med,2014,29(2):110-115.
[13]张延红,赵晓丽,刘岩,等,白雪.脑卒中患者气管切开术后吸痰方法的临床研究[J].河北医药,2014,36(7):1089-1090.
[14]杨淑梅,关淑芬,吴杨,等.两种吸痰法预防呼吸机相关性肺炎的效果研究[J].中华医院感染学杂志,2016,26(15):3398-3399,3408.
[15]毕娜,王建荣.改良深部吸痰法在重型颅脑损伤气管切开患者中的应用[J].解放军护理杂志,2015,32(12):6-9.
[16]叶向红,江方正,宋湘玲,等.腹腔内高压并存急性呼吸窘迫综合征患者吸痰方法的改进[J].护理学杂志,2016,31(2):66-68.
[17]麦燕华,刘群兰.两种吸痰法在烧伤合并吸入性损伤患者中的应用效果比较[J].齐鲁护理杂志,2017,23(20):111-113.
[18]李树伟,田秀芬.按压胸骨上窝联合浅部吸痰法用于重型颅脑损伤气管切开患者的研究[J].实用临床医药杂志,2015,19(18):10-12.
[19]汤云,黄美霞,雍海荣.探讨重症患者气管切开术后有效吸痰的方法[J].护士进修杂志,2015,30(20):1907-1908.
[20]林真珠,楚阳,张国英,等.两种吸痰法对气管插管早产儿心率及氧饱和度的影响[J].海南医学,2014,25(5):771-773.