气道分级管理方案配合音乐刺激疗法对老年肺炎机械通气患者脱机时间及谵妄的影响

Effects of graded airway management regimen combined with music stimulation therapy on weaning time and delirium in elderly pneumonia patients undergoing mechanical ventilation

目的探究气道分级管理方案配合音乐刺激疗法对老年肺炎机械通气患者脱机时间及谵妄的影响,为治疗该病症提供方法。方法选取2020年2月—2023年7月在锡山人民医院重症医学科接受机械通气治疗的老年肺炎患者80例,按随机信封法分为观察组和对照组,每组40例。对照组患者接受常规气道管理联合音乐刺激,观察组患者采用气道分级管理配合音乐刺激疗法治疗。记录并比较2组患者机械通气时间、一次性脱机成功率、住院时间、谵妄发生率及持续时间;评估并比较2组气道湿化效果及痰液分度。结果观察组机械通气时间、总住院时间均少于对照组,一次性脱机成功率高于对照组(均P<0.05);观察组谵妄发生率低于对照组(5.00%vs 22.50%,P<0.05);观察组谵妄持续时间少于对照组(P<0.05);观察组气道湿化满意率高于对照组(P<0.05);治疗后,观察组患者痰液粘稠度Ⅲ度的比例明显低于对照组(P<0.05)。结论气道分级管理方案配合音乐刺激疗法可缩短老年肺炎机械通气患者的脱机时间,减轻谵妄发生风险,并降低患者痰液粘稠度,在老年肺炎机械通气患者中具有一定的临床应用价值。

Objective To explore the effects of graded airway management regimen combined with music stimulation therapy on the weaning time and delirium in elderly pneumonia patients undergoing mechanical ventilation,and provide a method for the treatment of this disease.Methods Eighty elderly patients with pneumonia who received mechanical ventilation in Department of Critical Care Medicine of Xishan People's Hospital from February 2020 to July 2023 were selected and divided into observation group and control group by means of random envelope method,with 40 cases in each group.The patients in the control group received routine airway management combined with music stimulation,while the patients in the observation group were given graded airway management combined with music stimulation therapy.The mechanical ventilation time,success rate of one-time weaning,hospital stay,and incidence and duration of delirium were recorded and compared between the two groups.Airway humidification effect and sputum grading of the two groups were evaluated and compared.Results The mechanical ventilation time and total hospital stay of the observation group were shorter than those of the control group,and the success rate of one-time weaning was higher than that of the control group(P<0.05).The incidence of delirium was 5.00%in the observation group,which was lower than that in the control group(22.50%)(P<0.05).The duration of delirium of the observation group was shorter than that of the control group(P<0.05).The airway humidification satisfaction rate in the observation group was higher than that in the control group(P<0.05).After treatment,the proportion of patients with sputum viscosity Ⅲ degree in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Graded airway management regimen combined with music stimulation therapy can shorten the weaning time,reduce the risk of delirium,and lower the sputum viscosity in elderly pneumonia patients undergoing mechanical ventilation.It has certain clinical application value in elderly pneumonia patients undergoing mechanical ventilation.