三步排痰法在重度吸入性损伤烧伤患者护理中的应用  

Application of the three-step sputum elimination in nursing patients with severe inhalation burns

作　　者：洪霞[1] 徐慧[2] 黄小平[1] 张玲莉[3] 胡素勤[3] 

机构地区：[1]中国人民解放军第一一八医院烧伤科,温州325000 [2]中国人民解放军第一一八医院门诊,温州325000 [3]中国人民解放军第一一八医院护理部,温州325000

出　　处：《中华现代护理杂志》2017年第34期4319-4321,共3页Chinese Journal of Modern Nursing

摘　　要：目的探讨三步排痰法预防烧伤合并重度吸入性损伤患者肺部并发症的效果。方法将2015年4月—2016年4月收治的81例烧伤合并重度吸入性损伤行人工气道的患者作为对照组，实施常规护理。将2016年5月—2017年4月收治的72例烧伤合并重度吸入性损伤行人工气道的患者作为观察组，采取三步排痰法进行肺部护理，一是充分有效的气道湿化，二是规范化的叩背流程，三是保证有效吸引。观察两组患者气管套管留置天数及肺部感染发生率。结果 观察组患者发生肺部感染13例，发生率为18.06%，对照组感染49例，发生率60.49%，差异有统计学意义（χ2=7.826，P〈0.01）。观察组气管套管留置天数为（14.02±1.21）d，低于对照组的（19.04±1.63）d，差异有统计学意义（t=3.563，P〈0.05）。结论烧伤合并重度吸入性损伤患者的治疗关键在于采取有效措施解除气道梗阻，保持患者呼吸道畅通。加强人工气道的管理，采取正确有效的排痰法，同时实施早期创面治疗可以改善临床疗效，减少肺部感染的发生。ObjectiveTo explore the effects of the three-step sputum elimination on preventing pulmonary complications in patients with burns complicated with severe inhalation injury.MethodsTotally 81 patients with burns complicated with severe inhalation injury who received artificial airway between April 2015 and April 2016 were selected as a control group who received conventional nursing, while another 72 patients with burns complicated with severe inhalation injury who received artificial airway from May 2016 to April 2017 were selected as an observation group who received pulmonary nursing with the three-step sputum elimination, namely, 1） sufficient and effective airway humidification, 2） standardized beating procedure, and 3） effective catherization. The number of days with indwelling cannula and the incidence of pulmonary infection between the patients in the two groups were then observed.ResultsTotally 13 patients in the observation group （18.06%） and 49 patients in the control group （60.49%） showed pulmonary infection （χ2=7.826, P〈0.01） . The number of days with indwelling cannula of the patients in the observation group, （14.02±1.21） d, was shorter than that of the patients in the control group, [ （19.04±1.63） d, （t=3.563, P〈0.05） ].ConclusionsThe key to treatment of patients with burns complicated with severe inhalation injury lies in effective measures taken to eliminate airway obstruction and ensure airway patency in patients. Enhanced management of artificial airway, correct and effective sputum elimination and early wound treatment can improve clinical efficacy and reduce the incidence of pulmonary infection.

关 键 词：烧伤 吸入性 人工气道 肺部感染 三步排痰法 

分 类 号：R473.6[医药卫生—护理学]