个性化护理联合序贯排痰护理对气管切开重症卒中患者呼吸状态及排痰情况的影响

The Effect of Personalized Nursing Combined With Sequential Sputum Discharge Nursing on Respiratory Status and Sputum Discharge in Patients with Severe Stroke after Tracheotomy

目的探讨个性化护理联合序贯排痰护理对气管切开重症卒中患者呼吸状态及排痰情况的影响。方法选择2022年1月至2023年12月辽宁省金秋医院ICU收治卒中后行气管切开辅助通气治疗患者86例,根据入院时间依次分为对照组和观察组,各43例。对照组给予常规护理干预,观察组给予个性化护理与序贯排痰护理干预。观察两组患者护理前后相关指标变化情况,评价护理效果。结果出ICU时,观察组及对照组呼吸系统动态顺应性(Cdyn)均高于入ICU时(P<0.05),且观察组升高幅度更大,气道阻力(Raw)均低于入ICU时,且观察组下降幅度更大。干预后,观察组患者每日排痰量较对照组更多,每天吸痰时间及次数较对照组更少(P<0.05);观察组痰液黏稠度低于对照组(P<0.05);观察组肺炎感染发生率低于对照组(P<0.05)。结论对气管切开重症卒中患者应用个性化护理联合序贯排痰护理,可有效改善患者的排痰情况,促进患者呼吸状态的恢复。

Objective To explore the impact of personalized nursing combined with sequential sputum removal nursing on the respiratory status and sputum expectoration of critically ill stroke patients with tracheostomy.Methods A total of 86 patients with stroke who underwent tracheostomy for assisted ventilation treatment in the ICU of Liaoning Golden Autumn Hospital from January 2022 to December 2023 were selected.According to the admission time,they were sequentially divided into a control group and an observation group,each with 43 cases.The control group received routine nursing intervention,while the observation group received personalized nursing and sequential sputum removal nursing intervention.The changes in related indicators before and after nursing in both groups of patients were observed to evaluate the nursing effects.Results Upon leaving the ICU,both the observation group and the control group had higher Cdyn compared to when they entered the ICU(P<0.05),with the observation group showing a greater increase.Raw was lower than when entering the ICU,with the observation group showing a greater decrease.After intervention,the patients in the observation group had more daily sputum expectoration than the control group,and the time and frequency of tracheal suction were less in the observation group than in the control group(P<0.05).The viscosity of sputum in the observation group was lower than that in the control group(P<0.05).The incidence of pneumonia in the observation group was lower than that in the control group(P<0.05).Conclusions The application of personalized nursing combined with sequential sputum removal nursing in critically ill stroke patients with tracheostomy can effectively improve the patients’sputum expectoration,promote the recovery of respiratory status.