循证护理在重型颅脑损伤并发急性呼吸窘迫综合征患者机械通气气道湿化和吸痰中的应用

Evidence-based nursing in the application of mechanical ventilation humidification and suctioning in the severe braininjury patients combined with ARDs

目的探讨循证护理在重型颅脑损伤并ARDS患者机械通气湿化和吸痰中的应用。方法选择人住我院ICU的重型颅脑损伤并ARDS建立人工气道机械通气患者78例，按随机数字表法分为观察组41例和对照组37例。对照组患者只给予机械通气常规护理，观察组患者在气道湿化和吸痰上实施循证护理。比较两组患者并发症发生率和吸痰后SpO2水平。结果观察组患者并发症的发生率明显低于对照组（P〈0．05）；观察组患者吸痰结束时、吸痰后1min、吸痰后5min血氧水平明显高于对照组（P〈0．05）。结论循证护理在重型颅脑损伤并ARDS患者机械通气湿化和吸痰中的应用可以有效减少机械通气患者并发症的发生率，有效减少SpO2的下降幅度。

Objective To investigate the application effect of evidence-based nursing in the humidification and suctioning severe brain injury patients combined with ARDS. Methods 78 cases of severe brain injury combined with ARDS who had received artificial airway mechanical ventilation in our hospital, were chosen from January 2009 to January 2013 and randomly divided into the observation group with 41 cases, and the control group with other 37 cases. The control group received usual mechanical ventilation nursing and humidification and suctioning, the observation group received the same nursing, and was given extra evidence-based nursing. We compared the incidence of complications and changes of SpO2 after suctioning. Results The incidences of irritating cough, airway bleeding, artificial airway clogging, pulmonary infection in the observation group, were lower than those of the control group （P 〈 0.05）. The SpO2 of observation group when suctioning ending, after suctioning 1 min and 5 rain, were also higher than those in the control group （P 〈 0.05）. Conclusion Evidence- based nursing care in the application of mechanical ventilation humidification and suctioning in the severe brain injury patients combined with ARDS, can effectively reduce the complications of mechanical ventilation and the SpO~ decline, and improve the quality of care of nursing staff, and reduce the cost of care.