改良自主呼吸实验法在高龄老年呼吸机患者撤机过程中的效果评价  

Application of Modified SBT Method in the Removal Process of Medical Ventilator in the Senile

作　　者：程婕 浦瑾 黄帅帅 郭乐菁 Cheng Jie;Pu Jin;Huang Shuaishuai;Guo Lejing(Department of Nursing,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院护理部,上海200040

出　　处：《老年医学与保健》2018年第4期438-441,共4页Geriatrics & Health Care

基　　金：复旦大学复星护理科研项目(FNF201637)

摘　　要：目的探讨改良自主呼吸实验(spontaneous breathing trial,SBT)法在高龄老年呼吸机患者撤机过程中的应用价值。方法选取2016年12月—2017年10月收治的30例高龄老年气管插管患者作为研究对象。将患者随机分为试验组和对照组,每组各15例,对照组采用传统的SBT法撤机,试验组采用改良的SBT法对患者进行撤机,观察指标:比较2组患者撤机成功率,比较2组患者在撤机期间心率及指末血氧饱和度的变化。结果试验的15例患者经过改良的SBT法撤机,14例成功撤机,只有1例撤机失败。对照组的15例患者经过传统的SBT法撤机,撤机成功的11例,有4例撤机失败,2组患者撤机成功和失败的比较差异有统计学意义(P<0.05);2组患者撤机前后的心率及指末血氧饱和度比较,对照组心率和指末血氧饱和度在3个时间点(分别是机械通气时、SBT进行2 h时、撤机后2 h)的比较中,差异有统计学意义(P<0.05);试验组的指末血氧饱和度差异有统计学意义(P<0.05)。结论在对高龄老年呼吸机患者进行撤机时,应采取改良的SBT法,能减少对高龄患者心肺功能的影响,提高撤机成功率。Objective To explore the application value of modified spontaneous breathing trial（SBT） method in the removal process of medical ventilator in the senile. Methods 30 senile cases of endotracheal intubation hospitalized during the period from December, 2016 to October, 2017 were selected and randomly divided into 2 groups： experimental group and control group, 15 in each; the traditional SBT method was applied in the removal process of medical ventilator in control group while the modified SBT method applied in experiment group; the success rates in ventilator removal and the changes of heart rate and terminal oxygen saturation in the 2 groups were compared. Results The removal of ventilator was successful in 14 cases but failed in 1 case in experiment group while it was successful in 11 cases but failed in 4 cases in control group, the difference between the 2 groups was of statistical difference（P0.05）; the comparison of the heart rates and the levels of terminal oxygen saturation at the 3 time points（in medical ventilation, 2 hours after SBT methods started and 2 hours after ventilator removal）in control group were of statistical difference（P0.05）; the levels of terminal oxygen saturation at the 3 time points in experiment group were statistically different（P0.05） while no statistical difference was found in heart rates at the 3 time points in experiment group（P0.05）. Conclusions The application of modified SBT method in the removal process of medical ventilator in the senile can decrease the impact of ventilator removal on the cardio-pulmonary function and raise the successful rate of ventilator removal.

关 键 词：改良SBT法 高龄老年患者 撤机 

分 类 号：R472[医药卫生—护理学]