督导式预警性干预联合密闭式吸痰法在急诊重症肺炎合并呼吸衰竭患者中的应用价值  

Application of supervised early warning intervention combined with closed suction method in emergency patients with severe pneumonia and respiratory failure

作　　者：张宁[1] 于亚军 徐亚楠 张颖[1] 张志忠[1] 崔洋 ZHANG Ning;YU Yajun;XU Ya’nan(Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京市100050

出　　处：《河北医药》2024年第17期2622-2625,共4页Hebei Medical Journal

基　　金：吴阶平医学基金会临床科研专项资助基金(编号:320.6750.2022-26-15)。

摘　　要：目的探讨督导式预警性干预联合密闭式吸痰法在急诊重症肺炎合并呼吸衰竭患者中的应用价值。方法回顾性分析,采集2020年5月至2023年4月行机械通气治疗的急诊重症肺炎合并呼吸衰竭患者88例,其中44例实施密闭式吸痰法干预的患者纳入对照组,其余44例实施督导式预警性干预联合密闭式吸痰法干预的患者纳入观察组。比较2组干预前、干预3 d时患者血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、干预1、3、5 d时痰液黏稠度、干预期间并发症发生情况、住院相关指标(机械通气时间、住ICU时间、住院时间)。结果干预3 d时,2组PaO_(2)均升高,PaCO_(2)均降低,且与对照组比较,观察组PaO_(2)高,PaCO_(2)低(P<0.05)。干预1、3、5 d时观察组痰液黏稠度均优于对照组(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。观察组机械通气时间、住ICU时间及住院时间均短于对照组(P<0.05)。结论督导式预警性干预联合密闭式吸痰法干预可改善急诊重症肺炎合并呼吸衰竭患者血气指标,改善患者痰液黏稠度、降低并发症发生率,有助于缩短患者机械通气时间及住院时间。Objective To explore the application value of supervised early warning intervention combined with closed suction method in emergency patients with severe pneumonia and respiratory failure.Methods This was a retrospective study including 88 emergency patients with severe pneumonia and respiratory failure treated with mechanical ventilation in our hospital from May 2020 to April 2023.They were randomized 1:1 to closed suction method(control group)or supervised early warning intervention combined with closed suction method(observation group).The blood gas indexes(arterial partial pressure of oxygen[PaO_(2)],arterial partial pressure of carbon dioxide[PaCO_(2)])at day 0,3 of intervention,sputum viscosity at days 1,3,and 5 of intervention,complications,and hospitalization related indexes(mechanical ventilation time,ICU time,hospitalization time)were compared between groups.Results At days 3 of intervention,both groups showed significantly increase PaO_(2) and a decrease in PaCO_(2),with inter group significant difference(P<0.05).The sputum viscosity in the observation group was better than that in the control group at days 13 and 5 of intervention(P<0.05).Compared with the control group,the observation group had significantly lower overall incidence of complications,shorter mechanical ventilation time,ICU stay time,and hospitalization time(all P<0.05).Conclusion The combination of supervised early warning intervention and closed suction method can improve the blood gas indicators of emergency patients with severe pneumonia and respiratory failure,improve sputum viscosity,reduce the incidence of complications,and help shorten the mechanical ventilation time and hospitalization time of patients.

关 键 词：重症肺炎 呼吸衰竭 密闭式吸痰法 督导式预警性干预 并发症 

分 类 号：R563.1[医药卫生—呼吸系统]