严重颅脑损伤气管切开患者持续气道湿化的临床影响  

Clinical impact of continuous airway humidification on tracheotomy patients with severe craniocerebral injury

作　　者：申茂玲 朱广云 申智慧 

机构地区：[1]河南省封丘县人民医院护理部,河南封丘453300

出　　处：《中国医药导报》2011年第29期141-142,共2页China Medical Herald

摘　　要：目的:探讨持续湿化联合雾化、静脉给药对建立人工气道的临床影响。方法:沐舒坦(合并肺部感染者加入庆大霉素8万U)加入0.9%生理盐水500 ml持续气管套管滴入,每隔8 h静脉滴入一次。糜蛋白酶雾化吸入,持续氧气吸入,连续动态观察持续气道湿化后血气分析值、痰黏稠度情况。结果:观察建立人工气道后给予持续湿化、联合雾化、静脉给药、持续吸氧后,连续监测的第2、4、6、8天血气分析值均在正常范围内;痰液粘稠度分析:痰黏稠度Ⅰ度13例、Ⅱ度3例,均易被排出或吸出。结论:气道持续湿化、联合雾化、静脉给药,药物直接作用于肺组织,减少黏液腺的分泌,从而降低痰液黏度;促进肺表面活性物质的分泌,增加支气管纤毛运动,使痰液易于排出,并持续湿化吸氧,确保了呼吸道通畅和正常的血气分析值,对改善脑缺氧、脑损伤和控制肺部感染均具有十分重要的意义。Objective： To investigate the clinical impact of continuous humidification combined with spray and intravenous administration.Methods： Ambroxol（80 000 U of gentamicin was added for concurrent pulmonary infection） which was added to 0.9% saline solution for 500 ml,was administrated through continuous tracheal tube instillation,through intra venous drip every 8 hours.With chymotrypsin spray inhalation and continuous oxygen inhalation,blood gas analysis values and sputum viscosity situations were observed continuously and dynamically.Results： After the establishment of artificial airway,continuous humidification,combined spray and intravenous administration,and continuous oxygen inhalation were given.Continuous monitoring showed that on the 2nd day,4th day,6th day and 8th day,blood gas analysis values were within the normal range.Sputum viscosity analysis were found 13 cases of grade Ⅰviscosity and 3 cases of grade Ⅱ viscosity,which were all susceptible to exclusion or suction.Conclusion： In continuous airway humidification,combined spray and intravenous administration,the drugs directly act on the lung tissue to reduce mucus gland secretion,thereby reducing sputum viscosity.Also the drugs can promote the secretion of pulmonary surfactants and increase bronchial cilia movement,so that sputum can be easily removed.Continuous humidification and oxygen inhalation ensure the airway patency and normal blood gas analysis values,which are of great significance to improve cerebral anoxia,cerebral injury and control pulmonary infection.

关 键 词：严重颅脑损伤 人工 持续气道湿化 观察 

分 类 号：R651.15[医药卫生—外科学]