危重型新型冠状病毒肺炎患者人工气道规范化管理的实施  

Implementation of Artificial Airway Nursing Technique in Patients with Severe Coronavirus Disease 2019

作　　者：武淑萍[1,2] 罗淑平 袁熹娜 杨阳[2] 于江丽[2] 张昕 WU Shuping;LUO Shuping;YUAN Xin;YANG Yang;YU Jiang;ZHANG Xin(Department of Respiratory,The Second Medical Center of Chinese PLA General Hospital.Bejing 100853.China;National Clinical Research Center for Geriatric Diseases,General Hospital of PLABejing 100853,China;Department of Critical Care Medicine,Wuhan Huo Shen Shan Hospital,Wuhan 430100,Hubei Province,China;Department of Crtical Medicine,The 940th Hospital of the People's Liberation Army,Lanzhou 730050,Gansu Province,China;Department of Nursing,Wuban Huo Shen Shan Hospital)

机构地区：[1]解放军总医院第二医学中心呼吸内科,北京100853 [2]解放军总医院国家老年疾病临床医学研究中心,北京100853 [3]武汉火神山医院重症医学二科,湖北武汉430100 [4]联勤保障部队第九四O医院重症医学科,甘肃兰州730050 [5]武汉火神山医院护理部

出　　处：《解放军护理杂志》2020年第8期72-75,78,共5页Nursing Journal of Chinese People's Liberation Army

基　　金：军队保健专项科研课题(19BJZ32);新冠肺炎(COVID-19)应急医学科研项目(20yjky015).

摘　　要：目的探讨危重型新型冠状病毒肺炎有创机械通气患者人工气道规范化管理的实施方法。方法查阅国内外新型冠状病毒肺炎相关文献及人工气道护理相关文献,以护理技术专业化为前提,结合人工气道专项护理技术的管理经验,提出危重型新型冠状病毒肺炎患者有创机械通气期间人工气道专项护理技术的实施方法,并在38例危重型新型冠状病毒肺炎患者中进行实践应用。结果在人工气道固定、湿化、排痰及气囊管理等四个重点环节实施规范化管理,应用于38例危重型新型冠状病毒肺炎患者有创通气时的呼吸道管理,未发生意外脱管、皮肤黏膜损伤、痰痂或黏痰堵管、气囊压力性损伤等问题,取得了良好效果。结论人工气道规范化管理实施方法具有一定的实用性及科学性,可为危重型新型冠状病毒肺炎有创机械通气患者人工气道的护理提供临床指导。Objective To explore the implementation of standardized artificial airway management of critical patients with invasive mechanical ventilation and coronavirus disease 2019(COVID-19).Methods On the premise of nursing technical specialization,relevant documents of COVID-19 and related literature of artificial airway nursing were consulted.Combined with the working experience of epidemic prevention experts and the experience of artificial airway nursing technology in our hospital for years,the implementation method of special nursing technology of artificial airway for severe COVID-19 patients with invasive mechanical ventilation was put forward.It was applied in 38 patients with critical COVID-19.Results Standardized management was carried out in four key links of artificial airway fixation,humidification,sputum excretion and cuff management.The airway management in 38 patients with severe COVID-19 achieved a good result,without the occurrence of accidental extubation,skin mucosal injury,sputum scab or mucous tube blockage,and endotracheal tube cuff pressure injury.At the same time,the nursing staff’s operational satisfaction was high.Conclusions The standardized management and implementation method of the artificial airway has certain practicality and scientific,which can provide clinical guidance for the nursing of the artificial airway in critical COVID-19 patients with invasive mechanical ventilation.

关 键 词：新型冠状病毒肺炎 危重症 人工气道 护理 

分 类 号：R473[医药卫生—护理学] R473.51[医药卫生—临床医学]