长期机械通气患者人工气道更换的相关因素及护理对策

Analysis of Factors Responsible for Changes of Artificial Airway in Patients with Chronic Mechanic Ventilation

目的调查分析长期机械通气患者人工气道更换的相关因素,提出有效的护理对策。方法入选我院长期接受机械通气治疗的68例患者,统计其每次人工气道更换的相关因素,并进行结果分析。结果68例长期机械通气患者按计划更换人工气道174人次,非计划更换人工气道为59人次,其中气囊漏气占41%,导管脱出占38%,导管扭曲占16%,管道堵塞占8%。结论防止机械通气意外,避免非计划人工气道的更换,必须加强预见性护理,包括加强导管的固定和保护、加强气道湿化与排痰,以及做好气囊管理等。

Objective To investigate the factors for changes of artificial airway in patients with chronic mechanic ventilation and to put forward effective nursing strategy. Methods Totally 68 patients with chronic mechanic ventilation were enrolled in the present study. Factors responsible for changes of artificial airway were recorded and analyzed. Result There were 59 times of unplanned changes of artificial airway occurred in the overall 174 changes. Of the 59 times, cuff leaks were responsible for 41%, accidental extubation for 38%, tube twisting for 16% and obstruction for 8 0/40. Conclusion To prevent accidental mechanic ventilation and avoid un-planned changes of artificial airway, specific nursing cares, such as securing the airway and confirming placement, ensuring humidification and secretion clearance, and good management of cuffs should be given.