诱导性主动咳嗽在胸部术后护理中的应用研究

Effects of Inducing Cough in Postoperative Nursing in Patients with Thoracic Operations

目的探讨胸科术后患者最佳诱导性咳嗽方法及最佳诱导患者主动咳嗽的时机。方法将120例患者随机分成常规组、气管按压组、吸痰管刺激组3组,每组40例。3组患者均在手术清醒后2,6,18h实施诱导方法,观察不同方法应用前后患者的SPO2、有效咳嗽咳痰情况、诱导前后的感受情况及有无肺不张的发生。结果①术后6h和18h诱导咳嗽前后血氧饱和度变化△SPO23组间差异有统计学意义(P<0.05),气管按压组和吸痰管刺激组在术后6h的△SPO2与常规对照组差异均有统计学意义(P<0.05),吸痰管刺激组在术后18h的△SPO2变化情况与常规对照组差异有统计学意义(P<0.05)。②有效咳嗽率、有效咳痰率均为气管按压组>吸痰管刺激组>常规组。结论胸科术后6h实施气管按压法诱导患者主动咳嗽能够取得较好的效果。

Objective To explore the postoperative inducing methods and time of initiative cough and expectoration in patients with thoracic operations. Methods One hundred and twenty cases were randomly divided into three groups （ n = 40） ： the control group,pressing trachea group and suction tube stimulus group. The inducing methods were respectively given to patients in each group when they were conscious at 2 hours ,6 hours and 18 hours after the thoracic operations. Changes of SPO2 before and after the inducing methods, results of initiative cough and expectoration, feelings after given the inducing methods and incidence of atelectasis were observed. Results Changes of SPO2 were significantly different at 6 hours and 18 hours after the thoracic operations among the three groups （ P 〈 0. 05 ）. Changes of SPO2 in the pressing trachea group and the suction tube stimulus group were significantly different from the control group at 6 hours after the thoracic operations（P 〈0.05）. Only changes of SPO2 in the suction tube stimulus group was different from the control group at 18 hours after the thoracic operations （P 〈 0.05 ）. The incidence of initiative cough and expectoration in the pressing trachea group was better than that in suction tube stimulus group, while the latter was better than that in the control group. Conclusion Touching trachea or pressing on it at 6 hours after the operations can effectively induce the cough and expectorate in patients with thoracic operations.