床旁超声探查气管插管患者声门下分泌物及其滞留的危险因素分析  

Bedside ultrasound exploration of subglottic secretion in patients with tracheal intubation and retention risk factors analysis

作　　者：盖玉彪[1] 辛晨 林辉[1] 郭小靖[1] 张宇辰[1] 姚波[1] GAI Yubiao;XIN Chen;LIN Hui;GUO Xiaojing;ZHANG Yuchen;YAO Bo

机构地区：[1]青岛大学附属医院重症医学科,青岛市266000

出　　处：《中华急危重症护理杂志》2024年第1期28-32,共5页Chinese Journal of Emergency and Critical Care Nursing

基　　金：南京大学中国医院改革发展研究院课题项目(NDYG2023048)。

摘　　要：目的应用床旁超声探查气管插管患者声门下分泌物,并分析其滞留的危险因素。方法选取2023年1月-6月在综合ICU接受治疗的200例气管插管患者,通过床旁超声技术判断是否发生气管插管声门下分泌物滞留,分为滞留组与无滞留组。采用单因素分析气管插管患者声门下分泌物滞留的影响因素,并使用二元Logistic回归分析气管插管患者声门下分泌物滞留的高危因素。结果200例气管插管患者中声门下分泌物滞留的患者106例,占比53%。单因素分析显示,年龄、插管天数、插管材质、声门下吸引气管插管比例、留置胃管、8 mm气管插管、非全麻手术患者疾病种类比例是声门下分泌物滞留的影响因素。二元Logistic回归分析显示,年龄(OR=0.699)和留置胃管(OR=2.499)是声门下分泌物滞留的独立危险因素(P<0.05)。结论床旁超声在气管插管患者声门下分泌物探查中具有一定的应用价值,年龄和留置胃管是声门下分泌物滞留的独立危险因素,为临床护理人员加强气道管理提供了理论参考。Objective To explore the risk factors of subglottic secretion retention in patients with tracheal intubation by bedside ultrasound.Methods We selected 200 critically ill patients with tracheal intubation in ICU from January to June 2023.The ultrasound was used to distinguish the patients with retained subglottic secretions or not.The influencing factors of subglottic secretion retention in patients with tracheal intubation were analyzed by univariate factor analysis,and the high-risk factors of subglottic secretion retention in patients with tracheal intubation were analyzed by binary Logistic regression.Results Among the 200 patients with tracheal intubation,106 patients had subglottic secretions retention,accounting for 53%.Univariate statistical analysis showed that age,intubation days,intubation material,the proportion of tracheal intubation with subglottic suction,indwelling gastrictube,8 mm tracheal intubation and the disease type proportion of patients without general anesthesia operation were the influencing factors of subglottic secretion retention.Logistic regression analysis showed that only age(OR=0.699)and indwelling gastric tube(OR=2.499)were the risk factors of subglottic secretion retention.Conclusion Bedside ultrasound has certain application value in the exploration of subglottic secretion in patients with tracheal intubation,age and indwelling gastric tube are independent risk factors for subglottic secretion retention,which provided theoretical reference for clinical nurses to strengthen airway management.

关 键 词：插管法 气管内 声门下分泌物 超声检查 肺炎 呼吸机相关 危重病护理 

分 类 号：R473.5[医药卫生—护理学]