对接受气管插管机械通气的肺结核合并呼吸衰竭患者进行医护一体化综合气道护理的效果

Effect of integrated medical and comprehensive airway nursing for pulmonary tuberculosis patients with respiratory failure who received endotracheal intubation mechanical ventilation

目的:探讨并分析对接受气管插管机械通气的肺结核合并呼吸衰竭患者进行医护一体化综合气道护理的临床效果。方法:选择近年来在中山市第二人民医院进行气管插管机械通气的100例肺结核合并呼吸衰竭患者作为研究对象。将这些患者按照随机分组法分为观察组(n=50)与对照组(n=50)。对两组患者进行药物治疗与气管插管机械通气期间,分别采用医护一体化综合气道护理模式与常规护理模式对观察组患者与对照组患者进行护理,然后比较两组患者的血气指标〔包括动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、血液PH〕、治护后呼吸衰竭纠正的时间、呼吸机相关性肺炎(VAP)的发生率、住院的时间及其治疗的费用。结果:治护后,观察组患者的PaO_2高于对照组患者,其PaCO_2低于对照组患者,其呼吸衰竭纠正的时间和住院的时间均短于对照组患者,其治疗的费用低于对照组患者,差异有统计学意义,P<0.05。护理后,观察组患者VAP的总发生率低于对照组患者,差异无统计学意义,P<0.05。结论:对接受气管插管机械通气的肺结核合并呼吸衰竭患者进行医护一体化综合气道护理能显著改善其血气指标,缩短其呼吸衰竭纠正的时间和住院的时间,降低其VAP的发生率,减少其治疗的费用。

Objective:To explore and analyze the clinical effect of integrated airway care for pulmonary tuberculosis patients with respiratory failure who received endotracheal intubation mechanical ventilation.Methods:100 patients with pulmonary tuberculosis complicated with respiratory failure who received endotracheal intubation mechanical ventilation in Zhongshan Second People’s Hospital in recent years were selected as study subjects.The patients were randomly divided into observation group(n=50)and control group(n=50).On two groups of patients with drug treatment with endotracheal intubation during mechanical ventilation,using integrated airway nursing care integration mode and conventional nursing mode of observation group of patients and the control group patients with care,the patient’s blood gas index was compared between the two groups(including arterial blood oxygen partial pressure,arterial blood(PaO2)co2 partial pressure(PaCO2),blood PH),cure to protect the respiratory failure after correcting time,the incidence of ventilator associated pneumonia(VAP),hospitalization time and cost of treatment.Results:After treatment and care,PaO2 in the observation group was higher than that in the control group,PaCO2 was lower than that in the control group,the time to correct respiratory failure and the length of hospitalization were shorter than those in the control group,and the treatment cost was lower than that in the control group,with statistically significant difference(P<0.05).After nursing,the total incidence of VAP in the observation group was lower than that in the control group,with no statistically significant difference(P<0.05).Conclusion:Integrated medical and comprehensive airway care can significantly improve the blood gas index,shorten the time of respiratory failure correction and hospitalization,reduce the incidence of VAP,and reduce the cost of treatment for pulmonary tuberculosis patients with respiratory failure who receive endotracheal intubation mechanical ventilation.