风心病瓣膜置换术后肺保护性通气护理的效果评价  

Efficacy of lung protective ventilation nursingin rheumatic heart disease patients with valve replacement

作　　者：郭群凤[1] 

机构地区：[1]中南大学湘雅医院心胸外科,湖南长沙410008

出　　处：《实用临床医药杂志》2013年第16期153-155,共3页Journal of Clinical Medicine in Practice

摘　　要：目的 观察风心病瓣膜置换术后呼吸机肺保护性通气治疗的疗效及护理方法.方法 选择2011年5月-2012年5月在本院心胸外科行风心病瓣膜置换术后的患者300例,随机分成A组和B组,每组150例.A组给予保护性机械通气,潮气量设定为6～8 mL/kg;B组给予正常机械通气,潮气量设定为8～12 mL/kg.观察并比较护理后2组动脉血气分析PaO2、PaCO2、氧合指数、脱管时间及死亡率.结果 A组脱管时间较B组明显减少,差异有统计学意义（P＜0.05）;A组护理后PaO2、氧合指数较B组明显升高,PaCO2较B组明显降低,差异有统计学意义（P＜0.05）.结论 风心病瓣膜置换术后进行肺保护性通气护理可提高PaO2,降低PaCO2,改善氧合状况,缩短脱管时间,疗效安全有效.Objective To observe the efficacy of lung protective ventilation nursing in rheumatic heart disease patients with valve replacement.Methods Three hundred patients with rheumatic heart disease from May 2011 to May 2012 were randomly divided into protective mechanical ventilation group （Group A） with tidal volume of 6 to 8 mL/kg and the common mechanical ventilation group （Group B）with tidal volume of 8 to 12 mL/kg,150 cases in each group.A comparison was made upon the arterial blood gas analysis of PaO2,PaCO2,oxygenation index,as well as the slipping time of tube,and the mortality rate between the two groups.Results The slipping time of tube in Group A was significantly shorter compared with group B,the difference being statistically significant （P ＜ 0.05）.The PaO2 and oxygenation index in Group A was significantly higher compared with Group B,the PaCO2 in Group A was significantly lower compared with Group B,and the difference was statistically significant （P＜0.05）.Conclusion Our study indicats that lung protective ventilatory nursing is safe and effective in improving the PaO2 and oxygenation,lower PaCO2 in the treatment of rheumatic heart disease after valve replacement surgery.

关 键 词：风心病 瓣膜置换 肺保护性通气 护理 

分 类 号：R541.2[医药卫生—心血管疾病]