ICU老年危重患者行经皮扩张气管切开术加囊上吸引的护理对策和应用

The Countermeasures and Application on Nursing of Critically Ill Elderly Patients in ICU Underwent Percutaneous Expansion Tracheotomy and Capsule Attraction

目的探讨在ICU对经皮扩张气管切开术的老年患者囊上吸引的应用及护理对策。方法采用经皮微创气管切开术,应用囊上吸引术及气管切开术常规护理措施32例(应用组);取同期36例传统气管切开术,应用气管切开术常规护理36例作为对照组,观察呼吸机相关性肺炎发生率、机械通气时间及各种并发症的发生率。结果应用组呼吸机相关性肺炎发生率下降(P<0.05);两组机械通气时间、切口感染等无显著差异(P>0.05)。结论经皮微创气管切开术是一种安全、快捷的人工气道建立技术,应用囊上持续吸引及气管切开术常规护理等措施,有助于减少呼吸机相关性肺炎的发生,尤其适用于需长期机械通气的老年患者。

Objective： To explore the application on and nursing of elderly patients in the ICU who had percutaneous expansion tracheotomy and capsule attraction. Method ： 32 cases with minimally invasive percutaneous tracheostomy and application of bag attraction, who need long - term mechanical ventilation in critically ill ICU, and with conventional surgery and tracheotomy care measures were taken as the applying group. At the same time, 36 cases of the same period with conventional tracheostomy and routine nursing care as a control. Those two groups were observed for incidence of ventilator -associated pneumonia, duration of mechanical ventilation and all kinds of complications. Results ： The incidence of ventilator - associated pneumonia decreased （ P 〈 0.05 ） for minimally invasive percutaneous tracheotomy group. There was no significant difference（ P 〉 0.05 ） in time of mechanical ventilation, wound infection for both groups. Conclusion ： Percutaneous tracheostomy is a minimally invasive, safe, and efficient artificial airway building technology. Application of continuous sac attraction and tracheotomy care measures, such as routine nursing strategy, helps to reduce the incidence of ventilator - associated pneumonia, especially good for the elderly patients requiring long - term mechanical ventilation.