拔出气管插管护理方法预防吸入性肺炎的研究  

The Experimence of Different Nursing Methods of Extubation to Prevention Aspiration Pneumonia

作　　者：孔静[1] 张冬惠[1] 李晓钟[1] 王绍谦[1] 葛燕萍[1] 吴海霞[1] 张红莉[1] 

机构地区：[1]河南省开封市第二人民医院,河南开封475002

出　　处：《中国医学创新》2012年第33期60-61,共2页Medical Innovation of China

基　　金：河南省开封市科技局立项研究(编号:100337)

摘　　要：目的：探讨拔出气管插管时和拔出后不同护理方法预防吸入性肺炎的疗效。方法：将345例EICU的住院患者随机分为实验组174例和传统组171例。实验组拔管前给予双氧水和生理盐水进行口腔护理,再充分吸净口腔、咽腔、鼻腔及气道内的分泌物;吸痰管插至气管最深部后再拔出1cm,然后提拉捻转边吸引边拔管;拔管前6~8h禁食、拔管后2h禁食,且拔管前抽吸净胃内容物;如无禁忌证拔管时及拔管后持续抬高床头30°~45°;拔管后2h先协助患者更换体位,患者如无特殊不适,可给予温开水50ml入胃,饮水后1h内即不可立即更换体位,观察患者有无恶心、呕吐等反应,如无不良反应或胃潴留,1h后可给予米油100ml入胃,并逐渐增加饮食量和食物的黏稠度,同时,密切观察患者饮食后的反应。传统组采用传统拔管时和拔管后的护理方法。观察两组误吸的发生率和在EICU的住院时间。结果：实验组误吸6例（3.45%）,传统组误吸22例（12.87%）,差异有统计学意义（P〈0.01）;实验组在EICU住院时间为（8.3±6.9）d,传统组为（18.4±8.5）d,差异有统计学意义（P〈0.01）。结论：实验组的护理方法可有效的预防拔出气管导管时和拔出后误吸的发生率,从而降低吸入性肺炎的发生。Objective：To explore the effect of different nursing methods when and after Pulling out the tracheal intubation of prevention aspiration pneumonia. Method：345 cases of EICU’s hospital patients were randomly divided into the Experimental Group 174 examples and Traditional Group 171 examples,oral nursing by Hydrogen peroxide and Physiological saline before extubation in experimental group, fully suck the oral cavity, nose and throat, airway secretions, insert the Sputum suction pipe to the deepest point of tracheal and then pull out 1cm, abrosia 6~8 hours befoue and 2 hours after extubation,fully suck the stomach content,elevating the bed 30-45 degrees if there is no taboo. Help patients change position after extubion 2 hours,if patients without special discomfort, we can give 50 ml warm boiled water into the stomach, don’t change position after drinking within 1hour,and observe if patients have nausea and vomiting response, If no adverse reactions or stomach store stay, we feed patients with 100ml rice oil, and gradually increase the amount of food diet and viscosity, at the same time, closely observe patients’ reaction after eating. Traditional group treated by traditional methods of drawing tube and nursing methods.Observe the incidence rate of aspiration of two groups and in EICU hospital stays. Result：6 cases occurred aspiration in the experiment group,while 22 cases in the Traditional group , The EP in the EICU hospital stay was（8.3±6.9）days,while the TP was（18.4±8.5）days, the result of two groups was statistically significant （P0.01）. Conclusion：Nursing methods in the EP can effectively redue the aspiration incidence when and after Pulling out the tracheal intubation, which can reduce the aspiration pneumonia occurs.

关 键 词：气管插管 护理 肺炎 

分 类 号：R472.3[医药卫生—护理学]