持续湿化联合排痰机排痰治疗对神经外科重症并气管切开患者的应用效果评价

Evaluation of the effect of continuous humidification combined with expectoration machine in severe neurosurgical patients with tracheotomy

目的 探讨持续湿化联合排痰机排痰治疗对神经外科重症并气管切开患者的应用效果。方法 74例神经外科重症并气管切开患者,根据治疗方法不同分为对照组和观察组,每组37例。对照组采取雾化吸入结合人工叩背排痰治疗,观察组则采取持续湿化联合排痰机进行排痰治疗。比较两组临床疗效、拔管时间、住院时间及治疗前后动脉血氧饱和度(SaO2)、动脉血氧分压(PO2)、格拉斯哥昏迷评分,血压异常、肺部感染发生情况。结果 观察组治疗总有效率高于对照组,差异具有统计学意义(P<0.05);治疗后,观察组动脉血氧饱和度、动脉血氧分压、格拉斯哥昏迷评分分别为(97.56±2.21)%、(89.56±4.21)mm Hg(1 mm Hg=0.133 kPa)、(12.19±2.32)分,均优于对照组的(92.51±2.24)%、(76.51±3.25)mm Hg、(9.24±2.01)分,差异具有统计学意义(P<0.05);观察组拔管、住院时间分别为(12.37±2.21)、(17.37±2.45)d,均短于对照组的(18.55±2.91)、(22.31±2.41)d,差异具有统计学意义(P<0.05);观察组血压异常、肺部感染发生率为8.11%(3/37)低于对照组的27.03%(10/37);差异具有统计学意义(P<0.05)。结论 持续湿化联合排痰机进行排痰治疗神经外科重症并气管切开效果较好,可有效改善并发症与感染的发生率,值得临床推广。

Objective To discuss the application effect of different airway management models in severe neurosurgical patients with tracheotomy.Methods A total of 74 severe patients with tracheotomy in neurosurgery department were divided into control group and observation group by different treatment methods,with 37 cases in each group.The control group was treated with atomization inhalation combined with artificial percussion on the back for,while the observation group was treated with continuous humidification combined with expectoration machine.The clinical efficacy,extubation time,hospitalization time,arterial oxygen saturation(SaO2),arterial oxygen partial pressure(PO2),Glasgow coma score,occurrence of abnormal blood pressure and pulmonary infection was compared between the two groups.Results The total effective rate of treatment was 100.00% in the observation group,which was higher than 75.68% in the control group,and the difference was statistically significant(P<0.05).After treatment,the arterial oxygen saturation,arterial oxygen partial pressure and Glasgow coma score was(97.56±2.21)% ,(89.56±4.21)mmHg1mm Hg=0.133 kPa and(12.19±2.32)points respectively in the observation group,which was better than(92.51±2.24)% ,(76.51±3.25)mm Hg and(9.24±2.01)points in the control group,and their difference was statistically significant(P<0.05).The extubation time,hospitalization time was(12.37±2.21)and(17.37±2.45)d respectively in the observation group,which was shorter than(18.55±2.91)and(22.31±2.41)d in the control group,and their difference was statistically significant(P<0.05).The incidence of abnormal blood pressure and pulmonary infection was 8.11% (3/37)in the observation group,which was lower than 27.03% (10/37)in the control group,and the difference was statistically significant(P<0.05).Conclusion Continuous humidification combined with expectoration machine is effective in the treatment of severe neurosurgical patients with tracheotomy,and it can effectively lower the incidence of complications and infection.It is worthy of clinical promotion.