高龄呼吸衰竭患者撤机拔管后应用无创通气序贯治疗的护理  

Nursing of Aged Patients with Respiratory Failure by Noninvasive Intermittent Positive Pressure Ventilation Sequential Therapy following Trachea Cannula Extraction

作　　者：武淑萍[1] 田小京[1] 温江丽[1] 吴琳娜[1] 

机构地区：[1]解放军总医院南楼呼吸科,北京100853

出　　处：《解放军护理杂志》2012年第7期50-53,共4页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨老年呼吸衰竭机械通气患者撤机拔管后应用无创性通气序贯治疗的护理。方法方便性抽样选取2007年8月至2010年10月入住解放军总医院南楼呼吸科,临床诊断为Ⅱ型呼吸衰竭的患者60例,按照应用机械通气时间前后排序分组,单号为对照组,双号为试验组,每组各30例。撤机拔管后对照组给予常规治疗,试验组应用无创通气序贯治疗,观察两组患者治疗前、后、治疗间歇期动脉血气变化及康复和再插管例数。结果试验组患者治疗后及序贯治疗间歇期各项血气指标(除pH值外)明显改善(P<0.01),康复例数明显多于对照组(P<0.05),无再插管者(对照组为6例)。结论无创通气序贯治疗可进一步改善老年呼吸衰竭患者通气功能,促进康复;护理工作要严密监测生命体征,保持呼吸道通畅,加强心理支持,熟练掌握无创通气机的使用方法和性能。Objective To discuss the rational nursing of noninvasive ventilation sequential therapy of aged patients with respiratory failure after trachea cannula extraction.Methods From August 2007 to October 2010,60 patients with dinically diagrosed type Ⅱ respiratory failure were equally divided into experimental group（even numbers） and control group（odd numbers） based on the sequence of mechanical ventilation.After trachea cannula extraction,patients in the control group were treated with the routine methods and those in the experimentd group with sequential therapy of noninvasive intermittent positive ventilation.Changes of arterial blood gas and numbers of cured patients before treatment,after treatment and during intermittent number of re-intubation were compared accordingly.Results The arterial blood gas was significantly improved in the experimental group（P0.01）.While the numbers of cured patients in the experimental group were significantly more than that in the control group（P0.05）.Without re-intubated patients（6 patients in the control group）.Conclusion Noninvasive ventilation sequential therapy has advantage to heal the patients with respiratory failure.It is significant to attach close attention to vital signs,keep airway free,support psychosocially and master techniques of noninvasive mechanical ventilation.

关 键 词：无创通气 呼吸衰竭 老年人 序贯治疗 护理 

分 类 号：R473.5[医药卫生—护理学]