精细化护理在机械通气撤机患者中的应用

Application of fine nursing in patients with mechanical ventilation weaning

目的研究精细化护理对患者机械通气时间、一次撤机成功率、并发症的影响,分析机械通气撤机中应用精细化护理的体会。方法选取2016年6月-2018年6月在衢州市人民医院使用机械通气救治的患者92例,按照护理方式不同分为常规组和精细化护理组,每组46例,常规组给予常规护理,精细化护理组在常规组的基础上给予精细化护理,统计护理效果、并发症发生率和患者依从率。结果护理4周后,精细化护理组动脉血氧分压、动脉血氧饱和度高于常规组,二氧化碳分压、心率、呼吸频率、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、APACHE评分低于常规组(均P<0.05)。精细化护理组机械通气时间为(4.89±1.02)d,短于常规组的(10.52±1.62)d,差异有统计学意义(t=19.950,P<0.001);精细化护理组一次撤机成功率为78.26%(36/46),高于常规组的58.70%(27/46),差异有统计学意义(χ~2=4.079,P=0.043);并发症发生率为10.87%(5/46),显著低于常规组的28.26%(13/46),差异有统计学意义(χ~2=4.420,P=0.036);依从率为95.65%(44/46)高于常规组的82.61%(38/46),差异有统计学意义(χ~2=4.039,P=0.044)。结论在机械通气撤机患者中应用精细化护理能减少患者机械通气时间、提高一次撤机成功率、降低并发症发生率。

Objective To study the application experience of fine nursing in weaning of mechanical ventilation and its influence on the time of mechanical ventilation, the success rate of one-time evacuation and complications. Methods Total 92 patients who were treated by mechanical ventilation in Quzhou people’s hospital from June 2016 to June 2018 were divided into two groups according to the different nursing methods, 46 cases in each group. The routine group was given routine nursing, and the fine nursing group was given fine nursing on the basis of the routine group. The nursing effect, complication rate and patient compliance rate were counted. Results After 4 weeks of nursing, the levels of PaO2 and SaO2 in the fine nursing group were higher than those in the routine group, and the scores of PaCO2, HR, RR, SAS, SDS and Apache were lower than those in the routine group(all P<0.05). The mechanical ventilation time of the fine nursing group was(4.89±1.02) d, shorter than that of the routine group(10.52±1.62) d(t=19.950, P<0.001). The one-time weaning success rate of the fine nursing group was 78.26%(36/46), higher than that of the routine group 58.70%(27/46), χ2=4.079, P=0.043. The complication rate of the fine nursing group was 10.87%(5/46), significantly lower than that of the routine group 28.26%(13/46), χ2=4.420, P=0.036. The compliance rate of the fine nursing group was 95.65%(44/46), higher than that of 82.61%(38/46) in the control group(χ2=4.039, P=0.044). Conclusion Fine nursing can reduce the time of mechanical ventilation, improve the success rate of one-time weaning and reduce complications.