重症哮喘患者机械通气的作用及护理

The nursing care strategy with mechanical ventilation in severe asthma

目的：观察临床护理在重症哮喘患者机械通气治疗中的作用和配合.方法：收集常规治疗无效,采用机械通气治疗的18例入住ICU的重症哮喘患者资料,选择有工作经验的护理人员参与完成通气监护、镇静效果评估、及人工气道管理等护理工作,观察患者的临床转归、动脉血气指标.结果：18例患者经过2-8d,平均3.5d的机械通气的综合治疗,均抢救成功.撤机后循环及主要动脉血气指标（PaO2、PaCO2）明显改善,与机械通气前比较差异有显著意义（P〈0.01）.结论：机械通气是抢救重症哮喘患者的有效措施,治疗过程中心理护理、气道管理、正确的镇静效果评估等护理工作是保证疗效、减少并发症的重要环节.

Objective： To investigate the effects of mechanical ventilation combining with nursing care in severe bronchial asthma. Methods：The clinical data of 18 cases of acute severe bronchial asthma performed mechanical ventilation were analyzed. Nursing services such as ventilation monitoring, sedative assessment and artificial airway management were fulfilled by nurses with working experiences. Meanwhile, outcomes and arterial blood gas were observed. Results：All patients were treated successfully, and the duration of mechanical ventilation were from 2 to 8 days （average 3 days）. The indicators of circulation and arterial gas after weaning were improved significantly comparing with these before mechanical ventilation （P〈0.01）. Conclusion：Mechanical ventilation combining with sedative and muscle relaxant is an effective method to treat acute severe bronchial asthma. Mental nurs- ing, airway management and exact evaluation of sedative effect were the key to ensuring curative effect and decreasing complication.