院间转诊患者人工气道稳定性现状及影响因素研究

Stability of artificial airway in hospital referral patients and its influencing factors

目的:调查院间转诊患者人工气道稳定性现状,分析其影响因素,为规范院间转诊患者的人工气道管理提供依据。方法:采用自制转诊记录表对2015年3月至2018年3月转入我院急诊科的183例带人工气道的病例进行调查,采用单因素分析和多元回归分析院间转诊患者人工气道稳定性的影响因素。结果:本研究183例患者中,有31例(16.9%)发生人工气道导管移位。Logistic回归分析结果显示意识清楚、气管导管型号偏小、使用呼吸机、仅使用系带或面部胶带固定、使用搬抬式简易担架均为影响院间转诊患者人工气道稳定性的因素(P<0.05)。结论:院间转诊患者中有部分患者气管导管会发生移位,影响转运安全。转运过程中应针对患者意识、气管导管型号、是否机械通气、导管固定方法、搬运担架的选择等重要环节进行评估并采取有针对性的管理措施,提高人工气道患者转诊安全。

Objective: To investigate the artificial airway stability in interhospital referral patients, and to analyze its influencing factors, so as to provide reference for the management of artificial airway in patients with hospital referral. Methods: A self-designed questionnaire was used to investigate the information of 183 patients with artificial airway who was transferred to the emergency department of our hospital from March 2015 to March 2018. Univariate analysis and multiple regression analysis were used to analyze the influencing factors of artificial airway stability in hospital referral patients. Results: Totally 31 patients (16.9%) occurred artificial airway catheter displacement. Multivariate logistic regression analysis showed that patient with consciousness, the catheter size smaller than that of the patient, and the trachea catheter was fixed only with tie-wraps or tape, the use of simple stretcher were influential factors of artificial airway stability in patients with hospital referral (P<0.05). Conclusion: Some patients occur artificial airway catheter displacement during hospital referral. Hospital referral medical staff should understand the influencing factors of artificial airway stability and take targeted measures to improve the safety of patients with artificial airway referral.