院外气管切开患者交互式气道管理模式的建立

Establishment of an interactive airway management for out-of-hospital patients with tracheotomy

目的探讨新型气道管理模式在院外气管切开患者中的应用效果。方法选取2015年1月-2017年9月在我院治疗期间行气管切开术,并且在出院时仍处于气管切开状态的患者,随机分为观察组和对照组各42例。对照组患者采取常规护理模式进行出院护理,观察组患者采取交互式气道管理模式进行护理,对比分析2组患者的护理效果,包括套管脱出率,感染率(气道、切口、肺部),气道堵塞率,同时比较2组患者健康教育知识掌握程度、依从性及满意度。结果观察组套管脱出率为7.1%,明显低于对照组的26.2%,差异具有统计学意义(P<0.05);观察组的感染率为14.3%,低于对照组的45.2%,差异具有统计学意义(P<0.05);2组气道阻塞率比较无明显差异(P>0.05)。观察组健康教育知识掌握评分为(75.4±5.5)分,高于对照组的(71.7±5.3)分(P<0.05);观察组的依从性评分为(75.2±4.3)分,高于对照组的(71.9±4.6)分(P<0.05);观察组的满意度评分为(81.4±7.2)分,高于对照组的(76.9±5.2)分(P<0.05)。结论采用交互性气道管理模式可以有效降低出院气管切开患者气道感染、脱出等不良反应,同时提高其健康知识掌握程度和依从性,从而提升满意度,值得推广。

Objective To evaluate the extended care for a new airway management for out-of-hospital patients with tracheotomy. Methods 84 patients with tracheotomy between January 2015 and September 2017 were enrolled and all the patients were still in tracheotomy while they left the hospital. 42 patients in control group were cared with traditional nursing. The other 42 patients in observation group were cared with interactive airway management. The rates of casing pipe withdrawal,infection,airway obstruction between the two groups were compared. The knowing of airway management following tracheotomy,compliance,and satisfaction,were assessed in the groups. Results The rate of casing pipe withdrawal in observation group was lower than that in control group with 7.1% VS. 26.2%(P<0.05). The rates of infection between observation and control group were 14.3% VS. 45.2%(P<0.05). The occurrences of airway obstruction between the two groups made no significant difference(P>0.05). The score of test about knowing of airway management in observation group is higher than that in control group with(75.4±5.5)VS.(71.7±5.3)( P<0.05). The compliance in observation group is(75.2±4.3),higher than that in control group( 71.9±4.6)(P<0.05). The satisfaction score in observation is higher than that in control group(81.4 ±7.2)VS.(76.9 ±5.2)(P<0.05).Conclusion Contrast to the traditional care,interactive airway management might reduce the occurrence of casing pipe withdrawal,infection,airway obstruction. It should strengthen the knowing about airway management,compliance and improve the nursing satisfaction. It suggested that it should be used widely.