人工鼻在呼吸重症有创机械通气患者应用价值的初步研究

Preliminary study on the application value of artificial nose in critical patients with invasive mechanical ventilation

目的分析给重症有创机械通气患者应用人工鼻的价值。方法将2018年1月~2019年6月我院接收的重症有创机械通气患者共58例为研究对象,根据数字表法随机分成对照组(予以加温湿化器)与观察组(予以人工鼻)各29例,统计并比较两组的吸气阻力、呼气阻力、潮气量、分钟通气量、平均气道压、气道峰压、痰液黏稠度、满意度以及护理工作量情况。结果观察组的痰液黏稠度、吸气阻力、呼气阻力、潮气量、分钟通气量、平均气道压、气道峰压分别是(2.25±0.65)分、(18.85±2.51)cmH2O/(L·s)、(15.94±3.20)cmH2O/(L·s)、(593.65±136.25)mL、(8.20±1.71)L/min、(10.78±1.40)cmH2O、(27.10±3.15)cmH2O与对照组的(2.20±0.67)分、(18.26±3.62)cmH2O/(L·s)、(14.95±3.50)cmH2O/(L·s)、(596.36±120.54)mL、(8.38±2.20)L/min、(11.05±1.62)cmH2O、(27.29±2.65)cmH2O,差异不显著(P>0.05)。观察组的满意度是96.55%与对照组的93.10%差异不显著(P>0.05)。观察组的护理工作量是(2.65±0.45)h/d比对照组的(4.08±0.60)h/d更少(P<0.05)。结论人工鼻能于短期中代替加温湿化器给呼吸重症有创机械通气患者开展气道湿化,同时对呼吸力学的影响较小,患者满意度更高,能减少护理工作量,减轻护士的工作负荷,值得推广。

Objective To analyze the value of artificial nose incritical patients with invasive mechanical ventilation.Methods A total of 58 critical patients with invasive mechanical ventilation received in our hospital from January 2018 to June 2019 were selected as the research subjects.They were randomly divided into the control group(a warming humidifier was given)and the observation group(artificial nose was given)using the digital table method,with 29 cases in each group.The inspiratory resistance,expiratory resistance,tidal volume,minute ventilation,mean airway pressure,peak airway pressure,sputum viscosity,satisfaction and nursing workload were calculated and compared between the two groups.Results The sputum viscosity,inspiratory resistance,expiratory resistance,tidal volume,minute ventilation,mean airway pressure,and peak airway pressure of the observation group were(2.25±0.65)points and(18.85±2.51)cm H2O/(L·s),(15.94±3.20)cmH2O/(L·s),(593.65±136.25)mL,(8.20±1.71)L/min,(10.78±1.40)cmH2O,and(27.10±3.15)cmH2O respectively,which were not statistically different from those(2.20±0.67)points,(18.26±3.62)cmH2O/(L·s),(14.95±3.50)cmH2O/(L·s),(596.36±120.54)mL,(8.38±2.20)L/min,(11.05±1.62)cmH2O,(27.29±2.65)cmH2O of the control group(P>0.05).The satisfaction of the observation group and control group was 96.55%and 93.10%,respectively,and the difference was not significantly different(P>0.05).The nursing workload of the observation group was(2.65±0.45)h/d,which was less than that of the control group(4.08±0.60)h/d(P<0.05).Conclusion Artificial nose can replace the heated humidifier in the short term to carry out airway humidification in critical patients with invasive mechanical ventilation.At the same time,it has slight influence on respiratory mechanics,higher patient satisfaction,can reduce the workload of nursing,and is worthy of promotion.