ECMO联合机械通气治疗危重症患者气道管理标准化护理程序的探讨  

Discussion on Standardized Nursing Procedure of Airway Management in Critically Ill Patients Treated with ECMO Combined with Mechanical Ventilation

作　　者：张银英[1] 李振中[1] 杨葵珍[1] 廖小卒[1] ZHANG Yinying;LI Zhenzhong;YANG Kuizhen;LIAO Xiaozu(Department of Respiratory and Critical Care Medicine,Zhongshan People's Hospital,Guangdong Province,Zhongshan 528403,China)

机构地区：[1]广东省中山市人民医院呼吸与危重症医学科,中山528403

出　　处：《中国医药指南》2024年第23期157-160,共4页Guide of China Medicine

基　　金：2020年中山市社会公益与基础研究项目(2020B1016)。

摘　　要：目的分析对于体外膜肺氧合(ECMO)联合机械通气治疗的危重症患者接受标准化护理程序气道管理的应用效果。方法选取2020年5月至2022至12月本院收治的ECMO联合机械通气治疗的危重症患者80例为研究对象,基于随机数字表法分组,分别接受气道常规护理与标准化护理程序气道管理,依次记为对照组(n=40)与观察组(n=40)。对比观察两组患者术后临床症状改善情况,包括机械通气时间、ECMO治疗时间、呼吸困难缓解时间、住院时间,血气指标包括氧分压、二氧化碳分压、氧合指数变化,同时还观察两组并发症发生率。结果观察组治疗后机械通气时间、EMCO治疗时间、呼吸困难缓解时间、住院时间短于对照组(P<0.05);观察组经干预后PaO_(2)与氧合指数表达水平高于对照组,PaCO_(2)表达水平低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论在危重症患者接受ECMO联合机械通气治疗时,开展标准化护理程序气道管理,有助于促进患者病情转归,减少不良事件发生。Objective To analyze the application effect of standardized nursing procedures for airway management in critically ill patients treated with extracorporeal membrane oxygenation(ECMO)combined with mechanical ventilation.Methods Eighty critically ill patients treated with ECMO combined with mechanical ventilation in our hospital from May 2020 to December 2022 were selected as the study subjects.They were randomly divided into two groups using a random number table method:the control group(n=40)and the study group(n=40),receiving routine airway care(n=30)and standardized airway management procedures,respectively.Compare and observe the improvement of clinical symptoms after surgery between two groups of study subjects,including mechanical ventilation time,ECMO treatment time,respiratory distress relief time,hospital stay,blood gas indicators including oxygen partial pressure,carbon dioxide partial pressure,changes in oxygenation index,and the incidence of complications in both groups.Results The study group had shorter mechanical ventilation time,EMCO treatment time,respiratory distress relief time,and hospitalization time after treatment compared to the control group(P<0.05);After intervention,the expression levels of PaO_(2) and oxygenation index in the research group were higher than those in the control group,while the expression levels of PaCO_(2) were lower than those in the control group(P<0.05);The incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusions When critically ill patients receive ECMO combined with mechanical ventilation treatment,implementing standardized nursing procedures for airway management can help promote patient outcomes and reduce the occurrence of adverse events,which can be further promoted and applied in clinical practice.

关 键 词：危重患者 标准化护理程序气道管理 体外膜肺氧合 机械通气 

分 类 号：R473[医药卫生—护理学]