气道廓清技术在重型颅脑损伤气管切开患者气道管理中的应用  

Application of airway clearance technique in airway management of patients with severe craniocerebral injury undergoing tracheotomy

作　　者：许爱琴[1] 张丽 马小燕 赵娟[1] 陈琴 任璐 杨丹 李迎梅 方媛媛 祁彩霞 李海霞[1] XU Aiqing;ZHANG Li;MA Xiaoyan;ZHAO Juan;CHEN Qin;REN Lu;YANG Dan;LI Yingmei;FANG Yuanyuan;QI Caixia;LI Haixia(Neurosurgery Departement,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院神经外科,宁夏银川750002

出　　处：《宁夏医学杂志》2022年第1期46-48,共3页Ningxia Medical Journal

基　　金：宁夏卫生健康委员会重点研究课题(2016NW028)。

摘　　要：目的旨在评价气道廓清技术(ACT)在神经外科重型颅脑损伤气管切开患者气道管理中的应用效果。方法选取神经外科住院治疗的气管切开患者60例为研究对象,随机分为观察组与对照组各30例。2组患者在给予抗感染药物、祛痰药物等对症治疗的基础上,对照组给予常规治疗,包括抗感染药物治疗、雾化祛痰、气道湿化、翻身拍背,并在此基础上给予传统自体排痰技术协助排痰;观察组在对照组基础上给予气道廓清技术。比较2组患者痰液黏稠度、PO_(2)、PCO_(2)、SpO_(2)、气管套管带管时间。结果2组患者治疗后痰液黏稠度均有改善(P<0.05);2组患者PO_(2)、PCO_(2)、SpO_(2)水平均较治疗前明显改善(P<0.05),SpO_(2)水平在治疗后显著优于对照组(P<0.05);观察组患者气管套管带管时间较对照组明显缩短(P<0.05)。结论气道廓清技术能够有效排除痰液,可改善肺部通气功能、改善患者的痰液性状,有利于患者尽早拔除气管套管,改善患者的预后。Objective To evaluate the effect of airway clearance techniques(ACT)in airway management of patients with severe craniocerebral injury undergoing tracheotomy in neurosurgery.Methods The study was a prospective case-control study.A total of 60 patients with tracheotomy hospitalized in neurosurgery were divided into study group and control group,with 30 cases in each group.Both groups were given symptomatic treatment such as anti-infective drugs and expectorant drugs,and the control group was given routine treatment,including anti-infective drug treatment,atomization expectorant,airway humidification,turning over and clapping back.On this basis,traditional autologous expectoration technology was given to assist in expectoration.On the basis of the measures given to the control group,the study group was also given airway clearance technology.Results Compared with the control group,the viscosity degree of sputum in the study group was improved(P<0.05).PO_(2) in the study group was significantly better than that in the control group after one day and three days of treatment(P<0.05).There was no significant difference in PCO_(2) and SpO_(2) between the study group and the control group(P>0.05),and the time of endotracheal tube was significantly shortened(P<0.05).Conclusion Airway clearance technology can effectively remove sputum,improve pulmonary ventilation function,improve the properties of sputum,help patients remove tracheal cannula as soon as possible and improve the prognosis of patients.

关 键 词：重型颅脑损伤 气管切开 气道廓清技术 气道管理 

分 类 号：R473.6[医药卫生—护理学]