小导管气管套管内持续吸引在气管切开患者护理中的应用效果

Effect of continuous suction by small pipe in trachea cannula for patients after tracheotomy

目的 探讨小导管气管套管内持续吸引在气管切开患者护理中的应用效果.方法 采用目的抽样法选择宁波大学医学院附属医院2015年1月—2016年8月入住神经外科及ICU行气管切开后高气道分泌物的患者60例,根据随机数字表分为观察组和对照组各30例,两组均采用气切面罩联合呼吸机加温加湿器吸氧,无呼吸机应用.对照组采用气管切开常规护理方法,观察组采用气管切开常规护理方法加小导管气管套管内持续吸引.比较两组患者气管切开1周内呼吸道并发症发生情况和护理工作量.结果 观察组患者吸痰中发生刺激性咳嗽3例,呼吸道出血2例,低氧血症3例,低于对照组的21、14、16例,差异均有统计学意义（χ2值分别为22.500、12.273、13.017;P〈0.05）..观察组患者气管切开1周内常规吸痰（8.57±4.76）次,对照组（66.77±26.34）次,两组护理工作量比较差异有统计学意义（t=-11.908,P〈0.01）.结论 小导管气管套管内持续吸引能有效减少吸痰引起的呼吸道并发症,减少气管内吸痰次数,同时能减少护士的工作量,是一种安全有效的吸痰方法.

Objective To explore the effect of continuous suction by small pipe in trachea cannula for patients after tracheotomy.Methods Totally 60 patients with tracheotomy in Neurosurgery Ward and ICU, the Affiliated Hospital of School of Medicine of Ningbo University were included by purposive sampling from January 2015 to August 2016, and were divided into observation group （n=30） and control group （n=30） by random number table method. Tracheostomy mask joint oxygen Inhalation by heating humidifier was applied in both groups, without using breathing machine. Routine nursing methods of tracheotomy was carried out in the control group, while continuous suction by small pipe in trachea cannula were used in the observation group. Respiratory complications and nursing workload of the two groups were compared during the first week after tracheotomy.Results In observation group, there were 3 cases of irritative cough, 2 cases of respiratory hemorrhage, 3 cases of hypoxemia while sputum suctioning, and the complications rate was lower than control group（21, 14, 16）, the differences were statistically significant （χ2=22.500, 12.273, 13.017;P〈0.05）. Times of suction in observation group and control group were （8.57±4.76） and （66.77±26.34）, respectively, the difference was statistically significant （t=-11.908,P〈0.01）.Conclusions Continuous suction by small pipe in trachea cannula is a safe and effective method which could obviously reduce the respiratory complications while suctioning, decrease the times of endotracheal suction, as well as the workload of the nurse.