不同给水方式对机械通气病人口渴和并发症发生率的影响

Effects of different water supply methods on thirst and complications occurrence in mechanically ventilated patients

目的:探讨不同剂量的冰水喷雾法对重症监护室(ICU)机械通气病人口渴程度和并发症发生率的影响。方法:采取便利抽样法,选取2021年1月—2022年6月入住ICU经口气管插管的清醒病人作为研究对象,按随机数字表法随机分为3组,A组采取1.5 mL常温水注射法,B组采取1.5 mL冰水喷雾法,C组采取5.0 mL冰水喷雾法。比较3组口渴程度、口渴痛苦感、口腔黏膜湿润度、睡眠质量、相关并发症发生率及额外干预次数的差异。结果:重复测量方差分析结果显示,A组、B组、C组在07:30(T2)、11:30(T3)、19:30(T5)、23:30(T6)时段,降低口渴程度的疗效为C组>B组>A组,差异有统计学意义(P<0.01);在15:30(T4)时段,C组与B组的效果均优于A组,C组与B组差异无统计学意义(P>0.05);在干预第1天与第2天,C组与B组的睡眠质量优于A组,干预第1天口渴痛苦感与额外干预次数为C组<B组<A组,干预第2天,口渴痛苦感为C组<A组,额外干预次数为C组<B组<A组,差异有统计学意义(P<0.01);C组病人咬吐气管插管的发生率降低,与A组比较差异有统计学意义(P<0.05),3组在呛咳、烦躁、非计划性拔管、腹胀、腹痛发生率方面差异无统计学意义(P>0.05)。结论:与1.5 mL常温水和冰水喷雾比较,5.0 mL冰水喷雾法能够有效降低ICU经口气管插管病人的口渴程度与口渴痛苦感、额外干预次数及咬吐气管插管的发生率,提升病人的睡眠质量。

Objective:To investigate the effect of different doses of ice water spray on thirst degree and complications occurrence of ICU mechanical ventilation patients.Methods:From January 2021 to June 2022,convenience sampling was used to select awake patients admitted to ICU and intubated with orotracheal tube as the research objects.They were randomly divided into 3 groups according to the random number table method.Group A received 1.5 mL normal temperature water injection,group B was treated with 1.5 mL ice water spray,group C was treated with 5.0 mL ice water spray.The thirst degree,thirst pain,oral mucosa moisture,sleep quality,related complications and times of additional intervention were compared in the three groups.Results:The results of repeated measures analysis of variance showed that the curative effect of reducing the degree of thirst in groups A,B,and C at 07:30(T2),11:30(T3),19:30(T5),23:30(T6)was group C>B>A,and the difference was statistically significant(P<0.01).At 15:30(T4),the effect of group C and B was better than group A.There was no significant difference between group C and group B(P>0.05).The sleep quality of the patients was better than that of the group A,and the thirst and pain and the number of additional interventions were in the group C<B<A,and the difference was statistically significant(P<0.01).Compared with group A,the difference was statistically significant(P<0.05).There was no statistical significance in aspiration,irritability,unplanned extubation,abdominal distention and abdominal pain among the three groups(P>0.05).Conclusion:Compared with 1.5 mL normal temperature water and ice water,5.0 mL ice water spray can effectively reduce the degree of thirst and thirst pain,number of additional interventions and incidence of bite and exhalation tube intubation in ICU patients with airway intubation,and improve the sleep quality of patients.