膨肺联合震颤排痰法在ICU完全控制通气患者中的应用  

Application of inflating lung and tremor sputum discharge in full control of ventilation patients nursing in ICU

作　　者：申艳玲[1] 魏晓梅[1] 李杰红[1] 

机构地区：[1]中日友好医院ICU,北京100029

出　　处：《中华现代护理杂志》2011年第35期4285-4288,共4页Chinese Journal of Modern Nursing

摘　　要：目的探讨膨肺联合震颤排痰法在ICU无自主呼吸完全依赖呼吸机进行机械通气患者的临床护理效果。方法选取42例完全依赖呼吸机进行机械通气的患者为研究对象，随机分为实验组21例和对照组21例。实验组采用膨肺十震颤排痰法促进排痰，而对照组采取传统的翻身扣背方法促进排痰。比较两组患者治疗前后1—5dpH值、PCO2、PaO2、氧合指数、白细胞数、体温值及治疗后排痰量、机械通气时间、平均住院天数、肺不张发生例数及吸痰次数。结果两组患者pH、PCO2、PaO2值治疗前差异均无统计学意义（P〉0．05）；治疗后实验组患者氧合指数（394．25±52．29）mmHg高于对照组（344．27±23．56）mmHg，差异具有统计学意义（t=3．9935，P〈0．05）；两组治疗后白细胞数及体温值均降低并趋于正常，且实验组白细胞数（10．80±1．54）×10^9／L与体温（36．8±0．6）℃均低于对照组（12．10±2．21）×10^9／L，（37．9±0．4）℃，差异均有统计学意义（t=2．2116，6．9886；P〈0．05）。治疗后实验组平均排痰量（30．46±0．83）HIl高于对照组（20．51±1．16）ml，差异有统计学意义（t=31．9672，P〈Q05）；实验组机械通气时间（1．9±0．7）d，平均住院天数（9．1±0．8）d，吸痰次数（3±1）次均低于对照组（4．2±2．4）d，（15．1±3．0）d，（7±2）次，差异均有统计学意义（t=4．2160，8．8374，8．1976；P〈0．05）。实验组肺不张的发生率1例低于对照组7例。结论采用膨肺联合震颤排痰法对无自主呼吸机械通气患者进行肺部物理治疗，效果优于传统扣背法，可进行临床推广应用。Objective To-explore the clinical nursing effects of inflating lung and tremor sputum discharge on patients completely rely on full control of ventilation without autonomous respiration in ICU. Methods Totals of 42 patients received full control of ventilation were randomly divided into experimental group and control group , and per group had 21 cases. Experimental group received inflating lung and tremor sputum discharge method while control group received traditional clapping-back method to promote sputum discharge. Many index such as pH number, the pressure of oxygen, the pressure of carbon dioxide, leukocyte count, temperature value, sputum volume, mechanical ventilation time, hospitalization time, atelectasis incidence and sucking phlegm times , before and after treatment 1 - 5 days, were observed and compared. Results Before treatment, there was no difference in PH number, blood oxygen saturation, pressure of oxygen, pressure of carbon dioxide between two groups （ P 〉 0. 05 ）. After treatment, blood oxygen saturation of experimental group was （ 394.25 ± 52.29 ） mm Hg higher than （ 344.27 ± 23.56 ） mm Hg that of control group, and the difference was statistical difference（ t = 3. 9935 ,P 〈 O. 05 ）. In experimental group leukocyte count （ 10.80 ± 1.54） ×10^9/L and temperature （36. 8 ±0. 6）℃ both were closely to normal and lower than control group that was （12. 10 ± 2.21 ） ×10^9/L and（37.9 ±0.4）℃ respectively ,and differences were statistical difference（ t = 2. 211 6,6. 988 6 ; P 〈 0. 05 ）. Average sputum volume of experimental group was （ 30.46 ± 0.83 ） ml higher than （ 20.51 ± 1.16 ） ml of control group, and the difference was statistical difference （t = 31. 967 2, P 〈 0. 05 ） ;In experimental group, mechanical ventilation time was （ 1.9 ± 0.7 ） d, average hospitalization time was （9.1 ± 0.8 ） d, suction times was （3 ± 1 ） lower than that of control group was （ 4.2 ± 2.4 ） d, （ 15. 1± 3.0 ） d and （ 7 ± 2 ）, di

关 键 词：ICU 膨肺 震颤排痰 机械通气 

分 类 号：R472[医药卫生—护理学]