机械通气患者拔管后吞咽障碍危险因素分析及护理对策  

The risk factors and nursing strategies of dysphagia after endotracheal extubation in mechanically ventilated patients

作　　者：郝桂华[1] 于帮旭[2] 孙运波[2] 代明营[2] 方巍[2] 

机构地区：[1]青岛大学医学院护理学院,青岛市266003 [2]青岛大学医学院附属医院ICU

出　　处：《中华护理杂志》2012年第10期889-891,共3页Chinese Journal of Nursing

摘　　要：目的探讨机械通气患者拔管后吞咽障碍的发病率、危险因素并提出相应的护理对策。方法应用标准吞咽功能评定量表(SSA),对158例机械通气患者拔管后24h内进行吞咽评估,并根据有无吞咽障碍将患者分为两组,有吞咽障碍的为观察组,无吞咽障碍的为对照组,对两组患者的多个可能影响因素进行单因素分析和logistic多元回归分析。结果拔管后吞咽障碍发病率为55.1%,单因素分析表明,观察组患者的年龄、带管时间、机械通气时间及气管切开情况与对照组比较均有统计学意义(P<0.05)。回归分析显示,年龄、气管切开、带管时间>72h是拔管后吞咽困难的危险因素。结论拔管后吞咽障碍发病率较高,而患者的年龄、气管切开及带管时间>72h与拔管后吞咽障碍密切相关,提示对该类患者应采取相应护理措施,提高患者吞咽功能,减少并发症。Objective To investigate the incidence,risk factors and nursing strategies of dysphagia after endotracheal extubation in mechanically ventilated patients. Methods The swallowing functions were measured by using the Standardized Swallowing Assessment（SSA） within 24 hours after endotracheal extubation in 158 mechanically ventilated patients. Logistic regression analysis was used to examine the risk factors of dysphagia. Results The incidence of dysphagia after endotracheal extubation was 55.1 percent. Logistic regression revealed that age,tracheotomy and the duration of mechanical ventilation were predictors of dysphagia. Conclusions The incidence of dysphagia after endotracheal extubation is relatively high. Age,tracheostnmy and the duration of mechanical ventilation are risk factors of dysphagia. Nurses should take targeted measures to improve the swallowing function and reduce the incidence of complications after endotracheal extubation.

关 键 词：通气机 机械 吞咽障碍 危险因素 护理 

分 类 号：R472[医药卫生—护理学]