word 开胸患者术后雾化吸入方式改进的临床观察.docVIP

开胸患者术后雾化吸入方式改进的临床观察 ?700? 开胸患 李珞畅 JournalofQiqiharUniversityofMedicine,2011,Vo1.32,No.5 者术后雾化吸人方式改进的临床观察 【摘要】目的探讨适用于开胸术后患者更理想的雾化吸入方式,以促进患者有效排痰,预防术后 肺部并发症.方法选择我科201O年1月～2O11年1月行全麻开胸患者800例,随机分为两组,相同 的雾化荆的前提下,实验组采用持续24h氧气雾化吸入5～10ml/h,根据痰液的粘稠度增减雾化吸入 液的速度;对照组采用氧气雾化吸入3次/d,15min/次,并根据痰液的粘稠度增减雾化吸入次数.结果 两组患者在雾化吸入后血气分析结果提示PH,POz,PCO值之间差异无显着性意义(Pgt;0.05),实 验组湿化适中例数多于对照组有统计学差异(Plt;0.01),湿化不足例数小于对照组有统计学差异(P lt;0.01),湿化过度例数无统计学差异(Pgt;0.05).结论开胸术后患者采用持续氧气雾化吸入更能 降低痰液的粘弹性,从而更利于痰液的排出. 【关键词】开胸手术雾化吸入护理 CiincialobservationfortheimprovementofinhalationwaysofpatientsafterthoracotomyLILuo—— chang. (DepartmentofCardiothoracicSurgical,theFirstAffiliatedHospital,ChongqingMedicalUniversity, Chongqing400016.theP.R.China.) [Abstract]0bjectiveToexplorethebetterwaytopromoteeffectiveexpectorationforpatients afterthoracotomyinhalation,tOpreventpostoperativepulmonarycomplications.MethodsFromJanuary 2010toJanuary2011,the800casesofanesthesiathoracotomypatientswerechosenandthenrandomly dividedinto2groups.Byusingthesameatomizingagent,theexperimentalgroupcontinuedtO24hoxy— geninhalationusing5—10ml/hour,accordingtOtheviscosityofsputumchangesthespeedofinhala— tionsolution;controlgroupwithoxygeninhalation3times/day,15min/time,andaccordingtOthe viscosityofsputuminhalationtimesofchange.ResultsTwogroupsofpatientsafterinhalationofblood gasanalysisshowedpH,PO2,PC()2wasnosignificantdifferencebetweenthevalueofsignificance(Pgt; 0.05),moderatewetexperimentalgroupthanthecontrolgroupthenumberofcasesweresignificantly different(Plt;0.O1),thenumberofcaseslesswetthanthecontrolgroupweresignificantlydifferent(P lt;0.01),wetoverthenumberofcasesnosignificantdifference(Pgt;0.05).ConclusionsThoracotomy patientsusingcontinuousoxygeninhalationcanreducetheviscoelasticityofsputum,andthusmorecon— ducivetOthedischargeofsputum. [Keywords]ThoracicsurgeryInhalationNursingcare 开胸手术术后患者均有气管内分泌物增多,加之术后切 口疼痛,呼吸活动受限,通气障碍,咳痰无力等因素,易诱发术 后肺不张,肺部感染等并发症.有效排痰不仅依赖于正确的 物理方法如翻身,叩背,而且与痰液粘弹性密切相关.雾化吸 人是临床上常规用于湿化痰液,协助排痰,防治术后肺部并发 症的主要措施之一.有文献对雾化吸人湿化剂和祛痰剂的选