改良经口气管导管固定方法对躁动患者的效果观察

Observation on the effect of modified fixation method of endotracheal tube on restless patients

目的：观察经口气管导管的固定改良对躁动患者口腔黏膜的保护作用。方法：选择2015年1月~2016年1月我院ICU科出现躁动患者120例作为研究对象,所有患者均需行经口气管插管,将其随机等分为试验组和对照组。对照组患者采用普通气管导管固定术对导管进行固定;试验组患者采用改良气管导管固定术对经口气管导管进行固定。比较两组患者经口气管导管置管期间口腔黏膜破损率、非计划性拔管率、导管重置率、导管咬破率及患者干预前后的Riker镇静和躁动评分变化。结果：试验组患者置管期间的口腔黏膜破损率、非计划性拔管率、导管重置率及导管咬破率均明显低于对照组（P〈0.05）。两组患者护理干预后Riker镇静和躁动评分均较干预前有明显降低,但试验组患者干预后Riker镇静和躁动评分明显低于对照组（P〈0.05）。结论：经口气管导管改良固定术可有效提高躁动患者导管的稳定性,有效保护置管患者的口腔,提高患者导管置管护理质量,利于患者疾病治疗。

Objective： To observe the protective effect of modified fixation of endotracheal tube on oral mucosa in restless patients. Methods： Selected 120 cases of restless patients who needed endotracheal intubation in ICU department of our hospital dated from January 2014 to January 2016 as research object and randomly divided them into two equal groups： experimental group and control group. In the control group,the tracheal tube was fixed by common tracheal tube fixation. In the experimental group,the tracheal tube was fixed by modified tracheal tube fixation method. The rate of oral mucosal disruption,unplanned extubation rate,catheter replacement rate,catheter bite rate,Riker sedation and restlessness scores before and after intervention were compared between these two groups during the management period of endotracheal tube. Results： The oral mucosal damage rate,unplanned extubation rate,catheter replacement rate and catheter bite rate were significantly lower in the experimental group than those in the control group（ P〈0. 05）. The Riker sedation and restlessness scores were significantly lower in the two groups after the nursing intervention. However,the Riker sedation and restlessness scores in the experimental group were significantly lower than those in the control group（ P〈0. 05）. Conclusion： The endotracheal tube fixation can effectively improve the stability of catheter in restless patients,thus protecting the mouth of patients with catheter and improving the quality of catheter care in patients. All these will help patients to improve disease treatment.