开展综合气道护理对气管切开术后患者的干预作用研究

Interventional Effect of Comprehensive Airway Nursing on Patients after Tracheotomy

目的探讨开展综合气道护理对气管切开术后患者的干预作用。方法将该院2016年1月—2018年12月的46例气管切开术后患者,随机分组,每组23例,常规护理组给予常规护理,综合气道护理组开展常规护理联合综合气道护理。比较两组护理总有效率;痰培养转阴的时间、呼吸道刺激性咳嗽消失时间、痰液黏稠消失时间;护理前后氧合指数、汉密尔顿抑郁评分、气道峰压;肺部感染发生率。结果综合气道护理组的护理总有效率是100.00%(23/23),常规护理组则是65.22%(15/23),差异有统计学意义(χ~2=9.684,P<0.05)。护理前两组氧合指数、汉密尔顿抑郁评分、气道峰压接近,差异无统计学意义(P>0.05);护理后综合气道护理组汉密尔顿抑郁评分、氧合指数、气道峰压(8.01±0.11)分、(175.11±27.55)mmHg、(23.45±1.21)cmH_2O优于常规护理组(12.01±1.12)分、(150.01±24.20)mmHg、(27.46±1.68)cmH_2O,差异有统计学意义(t=6.923、5.911、6.333,P<0.05)。综合气道护理组痰培养转阴的时间、呼吸道刺激性咳嗽消失时间、痰液黏稠消失时间(6.24±1.14)d、(4.25±1.22)d、(5.21±1.21)d优于常规护理组(8.51±2.01)d、(6.21±2.82)d、(7.57±2.36)d(t=7.564、6.913、7.911,P<0.05)。综合气道护理组肺部感染发生率低于常规护理组,差异有统计学意义(χ~2=4.212,P<0.05)。综合气道护理组出现1例,常规护理组出现了6例。结论气管切开术后患者实施常规护理联合综合气道护理效果确切,可有效改善患者的病情,加速症状消失,减少肺部感染的发生。

Objective To explore the intervention effect of comprehensive airway nursing on patients after tracheotomy.Methods 46 patients after tracheotomy from January 2016 to December 2018 in the hospital were randomly divided into 23 cases in each group.The routine care group was given routine care,and the comprehensive airway care group carried out routine care combined with comprehensive airway nursing.The total effective rate of nursing care was compared between the two groups;the time of sputum culture turning negative,the time of respiratory tract irritation cough disappearing,and the time of sputum viscous disappearing;oxygenation index,Hamilton depression score,peak airway pressure before and after care;incidence of pulmonary infection.Results The total effective rate of nursing in the comprehensive airway nursing group was 100.00%(23/23),and that in the conventional nursing group was 65.22%(15/23),the difference was statistically significant(χ2=8.121,P<0.05).The oxygenation index,Hamilton depression score,and peak airway pressure of the two groups before nursing were close,,the difference was not statistically significant(P>0.05);the oxygenation index,Hamilton depression score,peak airway pressure of(8.01±0.11)points,(175.11±27.55)mmHg,(23.45±1.21)cmH2O was better than the conventional care group(12.01±1.12)points,(150.01±24.20)mmHg,(27.46±1.68)cmH2O,the difference was statistically significant(t=6.923,5.911,6.333,P<0.05).The time of sputum culture turning negative in the comprehensive airway care group,the disappearance time of respiratory irritant cough,and the disappearance time of sputum viscous(6.24±1.14)d,(4.25±1.22)d,(5.21±1.21)d,better than the conventional care group(8.51±2.01)d,(6.21±2.82)d,(7.57±2.36)d,the difference was statistically significant(t=7.564,6.913,7.911,P<0.05).The incidence of pulmonary infection in the comprehensive airway care group was lower than that in the conventional care group,the difference was statistically significant(χ2=4.212,P<0.05).One patient appeared in the comprehensive airway nursing group,and six patients appeared in the conventional nursing group.Conclusion The effect of routine care combined with comprehensive airway care for patients after tracheotomy is definite,which can effectively improve the patient’s condition,accelerate the disappearance of symptoms,and reduce the incidence of lung infections.