分阶段心理护理对重症肌无力机械通气患者撤机时间的影响  

The impact of programmatic psychological nursing on the time length of ventilator weaning in myasthenia gravis patients with mechanical ventilation

作　　者：冯洁贞[1] 吴婉玲[1] 苏永静[1] 

机构地区：[1]中山大学附属第一医院神经科,广州510080

出　　处：《中华现代护理杂志》2010年第14期1656-1657,共2页Chinese Journal of Modern Nursing

摘　　要：目的探讨分阶段心理护理对重症肌无力机械通气期患者撤机时间的影响。方法选择重症肌无力机械通气期的ICU患者作为实验组（n=44），根据其生理基础、血气分析结果等确定其撤机时间，根据不同的过渡阶段应用护理程序对其实施有计划性、有针对性、个体化的心理护理，对照组（n=42）仅采用从CMV＋→SIMV＋→SPONT→间歇脱机→完全撤机的方法。记录并比较两组患者撤机的时间及住院天数。结果对照组平均撤机时间为18d，实验组为14d，实验组的撤机时间低于对照组，但差异无统计学意义（P=0．752）；对照组患者的住院天数比实验组长，差异有统计学意义（P=0．039）。结论在重症肌无力患者机械通气的不同阶段，及时有效地实施个体化的分阶段心理护理，可以缩短患者的撤机时间及住院天数，从而提高治疗护理效果，减轻了患者的痛苦及经济负担。Objective To investigate the impact of psychological nursing on time length of ventilator weaning in patients with myasthenia gravis （MG）. Methods Forty-four MG patients with mechanical ventilation were enrolled to the testing group. In this group, the time of ventilator weaning was determined according to the results of basic status and blood gas analysis. Furthermore, the designed, targeted and individuated psychological care was conducted in this group at different phases. In the control group, only the programmatic method of ventilator weaning was used with the steps of CMV, SIMV, SPONT, intermittence and completely weaning. The iime length of ventilator weaning and the length of stay were compared between two groups. Results The time length of weaning in testing group was 14 days comparing with 18 days in control group. Although there was no statistical significance （ P = 0. 752 ）, the time length of ventilator weaning in testing group was shorter than that in control group. The length of stay was longer in control group than that in testing group （P = O. 039）. Conclusions The time length of ventilator weaning and length of stay could be shortened with the designed, targeted and individuated psychological care during different phases of ventilator weaning in patients with MG. Therefore, the nursing efficacy would be improved and the pains and economic burden of patients would be relieved.

关 键 词：心理护理 重症肌无力 机械通气 

分 类 号：R473.74[医药卫生—护理学]