人工气道管理方案在HDU气管切开神经重症患者护理中的应用效果

Effect of artificial airway management in the care of neurocritical patients underwent tracheotomy in HDU

目的探讨人工气道管理方案在高依赖病房(HDU)气管切开神经重症患者护理中的应用效果。方法选取2020年1—12月在重庆市某医院康复医学科HDU病区收治的148例患者为研究对象。对照组研究对象为2019年1月—2020年12月收治的105例患者,研究组研究对象为2021年1月—2021年12月收治的43例患者。给予对照组患者常规气道管理,给予研究组患者实施HDU气管切开神经重症患者人工气道管理方案。比较2组患者干预后肺部感染发生率、气管切开封管成功率和封管时间。结果研究组患者封管成功率为67.44%,高于对照组的40.00%,差异有统计学意义(P<0.05)。研究组成功封管患者的带管时间7~69 d,平均(42.3±19.2)d;对照组成功封管患者带管时间15~182 d,平均(62.3±36.2)d。研究组患者带管时间短于对照组,差异有统计学意义(P<0.05)。同时,研究组患者带管时间<50 d人数所占比例为75.86%,高于对照组的45.24%,差异有统计学意义(P<0.05)。研究组患者肺部感染发生率为37.21%,低于对照组的78.10%,差异有统计学意义(P<0.05)。结论HDU气管切开神经重症患者人工气道管理方案应用于气管切开患者气道管理中的效果显著,可降低肺部感染发生率,缩短气管导管带管时间,提高生活质量,最终有利于患者回归家庭和社会,值得临床推广应用。

Objective To explore the effect of artificial airway management in the care of neurocritical patients underwent tracheotomy in the High Depend Unit(HDU).Methods A total of 148 patients admitted to the HDU ward of the Department of Rehabilitation Medicine of a hospital in Chongqing from January 2020 to December 2021 were selected as subjects.Subjects in the control group included 105 patients admitted from January 2019-December 2020,and subjects in the experimental group 43 patients admitted from January 2021-December 2021.Patients in the control group received conventional airway management and patients in the experimental group received artificial airway management.The incidence of pulmonary infection,success rates of tracheal tube sealing and sealing time after the intervention were compared between the 2 groups.Results The success rate of tube sealing in the experimental group was 67.44%,which was higher than that in the control group(40.00%),and the difference was statistically significant(P<0.05).The time to successful sealing of patients in the experimental group ranged from 7 to 69 d,with a mean of(42.3±19.2)d,while the time of living with a tube in patients with successful tube sealing in the control group ranged from 15 to 182 d,with a mean of(62.3±36.2)d.The time of living with a tube in patients in the experimental group was shorter than that in the control group,with a statistically significant difference(P<0.05).Meanwhile,the proportion of patients living with a tube shorter than 50 d in the experimental group was 75.86%,which was higher than that in the control group(45.24%),and the difference was statistically significant(P<0.05).The incidence of pulmonary infection for patients in the experimental group was 37.21%,which was lower than that in the control group(78.10%),and the difference was statistically significant(P<0.05).Conclusion The artificial airway management for neurocritical patients in HDU has a significant effect in the airway management of patients underwent tracheotomy,which can reduce the incidence of pulmonary infection,shorten the time of living with an endotracheal tube,improve the quality of life,and ultimately facilitate the eventual patients’return to their families and society.These benefits justify a wider application of this procedure in clinical practice.