老年急性脑卒中患者显性误吸致呼吸衰竭的临床特征及护理干预

Clinical features and nursing intervention of patients with acute cerebral apoplexy in elderly patients with acute respiratory failure

目的:探讨老年急性脑卒中患者显性误吸致呼吸衰竭的临床特征及护理干预。方法:以我院2015年11月—2017年11月收治的40例急性脑卒中并发显性误吸致呼吸衰竭的老年患者为例,对其进行临床救治与护理干预。观察患者治疗前后的呼吸功能及心功能情况。结果:急性脑卒中患者在发生显性误吸后,可导致呼吸衰竭发生,经治疗与观察后,发现并发急性心功能衰竭的患者有30例,因室性心律紊乱,心跳骤停造成死亡3例,经抢救与护理得到好转的有27例。而发展为ARDS的患者有10例,死亡5例。对所有患者治疗前后各项指标的观察,发现患者误吸6小时内的氧合指数、pH及PaO_2指标高于误吸前,并且差异比较明显(P<0.05),具有统计学意义。结论:对于急性脑卒中老年患者,发生显性误吸后,容易继发呼吸衰竭。为了预防并及时救治该类患者,需要做好预防与护理工作,从而有效清除吸入物的同时,确保患者呼吸通畅,达到改善患者预后的目的。

Objective： To explore the clinical features and nursing intervention in patients with acute cerebral apoplexy complicated with acute respiratory failure. Methods： Among 40 cases of acute cerebral apoplexy complicated with acute respiratory failure in our hospital from August 2015 to June 2016, the elderly patients were treated with clinical treatment and nursing intervention. The respiratory function and cardiac function before and after treatment were observed. Results： In the event of a dominant aspiration, the patients with acute cerebral apoplexy could cause respiratory failure after treatment and observation, it was found that 30 cases of patients with acute heart failure were complicated with ventricular arrhythmia, cardiac arrest caused 3 death cases, 27 cases were improved after the rescue and nursing. There were 10 cases of ARDS and 5 cases of death. All the indicators of patients before and after treatment were observed, it was found that the oxygenation index, pH and PaO2 index of patients with aspiration within 6 hours were higher than those before the aspiration, and the difference was of statistical significance, P〈0.05. Conclusion： The elderly patients with acute cerebral apoplexy were easy to develop respiratory failure after dominant aspiration. In order to prevent and treat the patients in time, it was necessary to have early prevention and nursing, so as to effectively remove the inhalation and ensure the patient＇s breathing was smooth, and to improve the prognosis of the patients.