急性重度有机磷农药中毒行机械通气患者人工气道的护理

Observation and nursing of airways in mechanically ventilated patients with ASOPP-induced respiratory failure

目的总结急性重度有机磷中毒（acute severe organophosphorus pesticide poisoning,ASOPP）行机械通气患者人工气道的护理措施。方法对2013年1月-2014年12月本科室收治的18例ASOPP行机械通气患者进行人工气道护理,包括预防拔管、气道湿化和吸痰、预防呼吸机相关性肺炎和拔管护理等。结果 18例ASOPP行机械通气患者中,16例机械通气时间2-15 d,中位数4.00 d,顺利撤机,痊愈后出院;2例因服用量过大,发生多脏器功能衰竭死亡。所有患者住院时间5-13 d,平均（6.50±2.42）d。结论根据ASOPP患者人工气道的特殊性进行护理,包括预防脱管、湿化气道和吸痰、预防人工气道感染和拔管护理等,能有效减少相关并发症的发生,促进患者早日康复。

Objective To summarize the measures for nursing mechanical ventilated patients who suffered from respiratory failure caused by acute severe organophosphorus pesticide poisoning （ASOPP）. Method Retrospectively, the nursing clinical data of 18 mechanically ventilated patients who suffered from ASOPP-induced respiratory failure in ICU from January 2013 to December 2014 were analyzed for summarizing the nursing measures concerning preventive extubation, airway humidification and sputum sucking, prevention of ventilator-associated pneumonia and final extubation. Result Sixteen ASOPP patients successfully recovered after hospital discharge and another two died from multiple organ function failure because of excessive pesticides. Conclusions Effective observation and nursing care of airways based on their characteristics in ASOPP patients including prevention of unexpected shedding , appropriate humidity of airways and prevention of infection of ventilator-associated pneumonia（VAP）. All of these measures can reduce complications and contribute to the early recovery of patients.