气道湿化护理对重症颅脑损伤术后气管切开的影响

Effect of airway humidification nursing on tracheotomy after operation for severe craniocerebral injury

目的 分析气道湿化护理对重症颅脑损伤术后气管切开的影响。方法 选取本院2016年5月至2018年10月收治的86例重症颅脑损伤患者,根据建档顺序不同分为观察组(n=43)和对照组(n=43),均行重症颅脑损伤术治疗,术后气管切开建立人工通气,期间给予对照组常规护理,对照组基础上观察组展开微量泵持续恒温气道湿化护理,比较2组气道湿化相关指标(每日吸痰次数、吸痰间隔时间、堵管时间)、湿化护理前及护理1个月后动脉血气氧合指数(OI)水平、并发症情况。结果 观察组每日吸痰次数少于对照组[(5.23±1.21)次比(8.36±2.10)次],吸痰间隔时间长于对照组[(2.20±1.18)h比(1.41±0.95)h],堵管时间短于对照组[(29.47±6.02)d比(34.68±8.74)d],两组比较差异均有统计学意义(均P<0.05);湿化护理后观察组动脉血气OI水平高于对照组[(446.98±30.57)mmHg比(410.57±28.20)mmHg,1mmHg=0.133kpa],两组比较差异有统计学意义(P<0.05);观察组肺部感染、气管黏膜充血、刺激性咳嗽、痰痂等并发症发生率均较对照组低(均P<0.05)。结论气道湿化护理应用于重症颅脑损伤术后气管切开患者,可有效缩短堵管时间,延长吸痰间隔时间,减少吸痰次数,改善动脉血气OI水平,降低并发症发生率。

Objective To analyze the effect of airway humidification nursing on tracheotomy after operation for severe craniocerebral injury. Methods 86 patients with severe craniocerebral injury treated in our hospital from May, 2016 to October, 2018 were divided into an observation group (n=43) and a control group (n=43) according to the order of archiving. All the patients were surgically treated;after the operation, artificial ventilation was established by tracheotomy. The control group was routinely cared during the period;in addition, the observation group was given continuous humidification nursing with micro-pump. The airway humidification related indicators (daily sputum suction times, sputum suction interval time, blocking time), arterial oxygen index (OI) level, and complications before and after 1 month’s humidification nursing were compared between these two groups. Results The number of suctions per day was lower, the interval between suctions was longer, the blocking time was shorter, and the level of arterial blood gas OI was higher in the observation group than in the control group [(5.23±1.21) vs.(8.36±2.10),(2.20±1.18) h vs.(1.41±0.95) h, and (29.47±6.02) d vs.(34.68±8.74) d, and (446.98±30.57) mmHg vs.(410.57±28.20) mmHg;all P < 0.05]. The incidence of complications such as pulmonary infection, tracheal mucosal congestion, irritative cough and sputum scab in the observation group was lower than that in the control group (P < 0.05). Conclusion The application of airway humidification nursing in tracheotomy patients after surgery for severe craniocerebral injury can effectively shorten the time of blockage, prolong the interval of sputum suctions, reduce the times of sputum suction and the incidence of complications, and improve the level of arterial blood gas OI.