脑出血术后昏迷患者保持呼吸道通畅的护理体会

Nursing Experience of Keeping Airway Tract Patency of Coma Patients after the Cerebral Hemorrhage Surgery

目的强化护理在脑出血术后昏迷患者保持呼吸道护理之中应用效果。方法选取2014年9月—2017年2月该院神经外科在改进前收治对象110例,入选对照组,采用常规护理,改进后,改进组收治对象84例。对比康复进程指标、呼吸道护理相关指标以及不良事件发生情况。结果改进组机械通气时间(35.6±11.6)h、吸氧时间(56.3±12.6)h,低于对照组(43.6±12.3)、(70.9±13.5)h,改进组出重症监护室动脉氧饱和度(96.8±1.1)%高于对照组(95.0±1.3)%,差异有统计学意义(P<0.05)。改进组,痰液粘稠度Ⅰ度、Ⅱ度、Ⅲ度分别占94.68%、5.32%、0.00%,低于对照组86.36%、10.91%、2.73%,差异有统计学意义(P<0.05)。改进组面罩压疮、不良事件合计发生率分别为11.7%、30.9%,低于对照组24.5%、60.9%,差异有统计学意义(P<0.05)。结论强化护理干预可改善患者预后。

Objective To enhance the application effect of keeping airway tract patency of coma patients after the cerebral hemorrhage surgery. Methods 110 cases of patients in the department of neurosurgery in our hospital from September 2014 to February 2017 were selected and adopted the routine nursing, after improvement, there were 84 cases in the improvement group, and the recovery process index, respiration tract nursing related indexes and occurrence of adverse reactions were compared between the two groups. Results The duration of mechanical ventilation and oxygen uptake in the improvement group were lower than those in the control group [（35.6±11.6）,（56.3±12.6）h vs（43.6±12.3）,（70.9±13.5）h], and the arterial oxygen saturation in ICU in the improvement group was higher than that in the control group[（96.8±1.1）% vs（95.0±1.3）%], and the difference was statistically significant（P〈0.05）, and the sputum viscosity Ⅰ, Ⅱ, Ⅲ in the improvement group were lower than those in the control group（94.68%,5.32%,0.00% vs86.36%,10.91%,2.73%）, and the differences were statistically significant（P〈0.05）, and the incidence rates of mask pressure cores and adverse events in the improvement group were lower than those in the control group（11.7%, 30.9%vs 24.5%, 60.9%）, and the difference was statistically significant（P〈0.05）. Conclusion The enhancement of nursing intervention can improve the prognosis of patients.