神经外科气管切开患者按需吸痰护理效果评价

The evaluation of nursing effect of demand-controlled sputum drainage in patients with tracheotomy at neurosurgery department

目的探讨按需吸痰在气管切开患者呼吸道管理中的应用效果。方法 100例神经外科气管切开患者按照气管切开手术先后顺序分为对照组和试验组各50例,对照组采用常规吸痰,试验组按需吸痰,综合考虑吸痰指征和时机,比较两个组别的吸痰效果及各评分指标。结果试验组每天吸痰次数、气道黏膜出血率、痰培养阳性率、肺炎发生率、痰液性质、气道通畅、黏膜状态等评分均明显低于对照组(P<0.05),舒适度评分、陪护心理反应评分均明显高于对照组(P<0.01)。结论按需吸痰可以减少气管黏膜损伤,降低肺部感染发生率,提升患者舒适度。

Objective To explore application effect of demand-controlled sputum drainage in respiratory tract management for patients with tracheotomy. Methods One hundred patients with tracheotomy at our department were divided into control group （ n = 50） or experiment group （n = 50）according to the order of operation. The control group adopted common sputum drainage while the experiment group used the method of demand-controlled sputum drainage according to indications and opportunity of sputum drainage. The effect of sputum drainage and various scores were compared between the two groups. Results Daily sputum drainage times, hemorrhage rate of tracheal mucosa, positive rate of sputum culture,incidence rate of pneumonia, sputamentum character score, airway smooth score and mucous membrane state score in the experiment group were much lower than that in the control group （ all P 〈 0. 05 ）. Moreover, the score of comfort and psychological reactions in the experiment group were much higher than that in the control group（P 〈 0. 01 ）. Conclusion The method of demand-controlled sputum drainage could reduce injury of respiratory tract mucosa, cut down incidence rates of pulmonary infection, and improve comfort degree of patients.