两种气道湿化方式在ICU气管切开脱机患者中的应用效果研究
Application effects of two airway humidification methods in ICU patients with tracheotomy
摘要目的? 比较ICU气管切开脱机患者采用雾化加湿器湿化与主动加热湿化器湿化方式的湿化效果.方法? 采用便利抽样法,选取2014年12月—2017年11月宜兴市第二人民医院重症医学科行气管切开且不需要行机械通气的患者57例作为研究对象,按随机数字表法随机分为对照组28例(雾化加湿器湿化)和观察组29例(主动加热湿化器湿化),比较两组患者痰量、吸痰次数、痰液黏稠度及血气分析指标的差异.结果? 观察组的每日吸痰次数、痰量较对照组少,痰液黏稠度较对照组低,差异具有统计学意义(P<0.05).观察组第7天血气分析结果优于对照组,差异有统计学意义(P<0.05).结论? 主动加热湿化器更有利于痰液的稀释和引流,有效改善ICU气管切开患者的氧合状况,维持较好的酸碱平衡;减少了护士在临床护理工作中反复且长时间的吸痰操作,减轻了对患者气道黏膜的损伤,能进一步提高气道管理的质量,提升护理效能.值得在临床推广.
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abstractsObjectiveTo compare the effects of airway humidification by atomization humidifier and heated humidifier on ICU patients with tracheotomy. Methods? Totally 57 patients who received tracheotomy and did not need mechanical ventilation from the Department of Critical Care Medicine of Yixing No.2 People's Hospital between December 2014 and November 2017 were selected by convenient sampling and divided into the control group (n=28) which received airway humidification by atomization humidifier and the observation group (n=29) which received airway humidification by heated humidifier according to the random number table. The differences in sputum quantity, number of daily sputum suction, sputum viscosity and blood gas analysis index were compared between the two groups. Results? The number of daily sputum suction, sputum volume and viscosity of sputum of the observation group were less than that of the control group (P<0.05). The observation group showed better blood gas analysis results than the control group on day 7 (P<0.05). Conclusions? The heated humidifier is better for dilution and drainage of sputum. It can effectively improve the oxygenation of ICU patients with tracheotomy, maintain better acid-base balance, lessen sputum suction procedures which would be repeated and time-consuming in clinical nursing care, reduce damage to patients' airway mucosa, and improve the quality of airway management, which is worth promoting in clinical practice.
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