老年无创机械通气两种连机顺序方式探讨.docVIP

精品论文 参考文献 老年无创机械通气两种连机顺序方式探讨 吴 迪 顾月琴 　　中国人民解放军总医院 北京 100853 　　【摘 要】目的：通过探讨不同连机顺序在提高患者耐受度及舒适度方面的效果调查，为临床应用无创呼吸机连机顺序提供参考。方法：以我院南楼轻中度急性呼吸衰竭80例患者随机分为观察组和对照组，对照组先将呼吸机管路与罩连接，机器自检后设置呼吸机参数，将罩扣于病人面（鼻）部，启动呼吸机；观察组先将罩与呼吸机管路及呼吸机连接，机器自检后设置呼吸机参数，启动呼吸机，再将罩扣于病人面（鼻）部。比较两组患者上机0min和上机30min的各项指标。结果：观察组人机同步情况及舒适度高于对照组。结论：用将罩与呼吸机管路及呼吸机连接，机器自检后设置呼吸机参数，启动呼吸机，再将罩扣于病人面（鼻）部的方式减少人机对抗，增加舒适度，值得临床推广。 　　【关键词】无创机械通气；连机顺序；人机同步；耐受度；舒适度 　　【中图分类号】R472 【文献标识码】A 【文章编号】1764-8999（2015）7-0500-01 　　Investigation of two different machine-connecting order in non-invasive mechanical ventilation of elderly patients 　　Wu Di Gu yue-qin 　　(General hospital of PLA, Beijing 100853,China) 　　【Abstract】Objective：To provide reference for the application of non-invasive ventilator machine-connecting order by investigating the effect of different machine-connecting order in improving patient tolerance and comfort.Methods：40 patients with acute respiratory failure were randomly divided into observation group and control group, the control group first connect the cover and the ventilator tubing and ventilator, and then set the ventilator parameters,after self-test of the machine, put the cover on patients face(nose),then start the machine at last; observation group first cover the ventilator tubing and ventilator connection, then set the ventilator parameters, start the machine after self-test,put the cover on patients face(nose)at last. Indicators of the 0min on-machine and 30min on-machine of the two groups were compared. Results：Synchronization conditions and comfort of the observation group are higher than the control group.Conclusion：The noninvasive mechanical ventilation should choose the way of the observation group. 　　【Key words】non-invasive mechanical ventilation;machine-connecting order; patient-ventilator synchrony;tolerance;comfort 　　无创机械通气作为一种协助通气方式，具有保留正常的吞咽、进食、咳嗽、说话功能；保留上气道的生理温化、湿化和免疫功能；呼吸机相关性肺炎的发生率低；病人从生理和心理上均较易撤机；可以间断、长期或家庭使用的优点。 　　患者使用无创呼吸机初期，由于生理和心理的不耐受，会产生人机配合差甚至不能配合，导致无创机械通气效果不佳的现象。引起患者不耐受的原因