气管插管拔出方法的改进  

The effect of a modified endotracheal extubation method

作　　者：孔静[1] 葛燕萍[1] 祁相焕[1] 吴海霞[1] 张红莉[1] 

机构地区：[1]开封市第二人民医院急诊医学科,河南开封475002

出　　处：《护理学杂志》2015年第11期12-14,共3页

基　　金：开封市科技发展计划课题(100337)

摘　　要：目的探讨改良式气管导管拔出方法的效果。方法将436例收治于急诊科ICU的气管插管患者采用抽签法随机分为改良组224例和传统组212例。改良组拔管前后减少胃内滞留物并清洁口、鼻腔,采取正压通气拔管法拔出气管导管;传统组采用一般口腔护理,边吸引边拔管的常规法拔出气管导管。结果拔管后5min、10min、30min两组动脉血气指标及SpO2比较,改良组变化幅度显著小于传统组(均P<0.01)。改良组并发症发生率显著低于传统组,拔管后住院时间显著短于传统组(均P<0.01)。结论改良式气管导管拔出方法能够有效防止低氧血症的发生;降低胃内压,减少因胃潴留造成的腹内高压引起的误吸,降低吸入性肺炎的发生,从而缩短拔管后住院时间。Objective To investigate the effect of a modified extubation method. Methods A total of 436 ICU patients were randomly divided into a modified group of 224 cases and a traditional group of 212 ones. For the former group, mimization of gastric contents was done, and the mouth and nostrils of the patients were cleaned before extubation, then extubation was later performed under positive pressure ventilation. For the latter group the endotraeheal tubes were pulled out during suctioning. Results The blood gas results and arterial SpO2 5 min, 10 min and 30 min after extubation in the modified group were significantly smaller than the tradi- tional group （P〈0.01 for all）. The incidence of complications of the modified group was significantly lower than the traditional group, and hospital stay after extubation was also shorter than traditional group （P〈0.01 for both）. Conclusion The modified en dotraeheal extubation method can prevent the occurrence of hypoxemia effectively. By lowering intragastric pressure and reducing aspiration resulting from intra-abdominal hypertension caused by gastric retention, it can also shorten the length of hospital stay af- ter extubation.

关 键 词：重症患者 急诊科 ICU 气管导管 拔管 正压通气 动脉血气 

分 类 号：R472[医药卫生—护理学]