可视喉镜在TICU患者气道护理中应用.docVIP

可视喉镜在TICU患者气道护理中应用 　　[摘要] 目的 探讨使用可视喉镜吸痰在创伤加强监护病房（TICU）患者中的应用价值。 方法 将2016年8月～2017年5月入住TICU的排痰受限患者102例随机分为可视喉镜下吸痰组（A组）51例，常规吸痰组（B组）51例，分别给予可视喉镜可视下吸痰及常规方法吸痰。观察记录两组患者入住TICU后7 d内人工开放气道率（气管插管或气切）、肺部感染率、人工开放气道前吸痰率、口鼻咽出血并发症发生率等。 结果 A组7 d内人工开放气道率（气切或气管插管）、肺部感染发生率、人工气道在开放前吸痰率、口鼻咽喉部位出血发生率均低于B组，组间比较，差异有统计学意义（P0.05）。 结论 可视喉镜在对TICU患者排痰受限气道护理中痰液清除效率较常规吸痰方法更为有效。 　　[关键词] 可视喉镜；气道护理；吸痰；肺部感染 　　[中图分类号] R473 [文献标识码] B [文章编号] 1673-9701（2017）30-0149-04 　　[Abstract] Objective To explore the application value of visual laryngoscopy in patients of traumatic intensive care unit （TICU）. Methods A total of 102 patients with limited expectoration who were admitted in TCIU from August 2016 to May 2017 were randomly divided into suction under visual laryngoscopy group（group A， n=51） and conventional suction group（group B， n=51）. The group A and group B was given suction under visual laryngoscope and conventional methods of suction， respectively. The artificially airway opening rate（tracheal intubation or pneumothorax）， lung infection rate， aspiration rate before opening artificial airway， and the incidence of nasopharyngeal hemorrhage complications of the two groups were recorded within 7 days after admission to TICU. Results The artificially airway opening rate （tracheal intubation or pneumothorax）， lung infection rate， aspiration rate before opening artificial airway， and the incidence of nasopharyngeal hemorrhage complications within 7 days of the group A were lower than those of the group B， and there was significant difference between two groups（P0.05）. Conclusion The efficacy of visible laryngoscopy in the removal of sputum in TICU patients with expectoration and limited airway is more effective than conventional suction method. 　　[Key words] Visible laryngoscopy； Airway care； Suction； Pulmonary infection 　　在重?Y监护病房住院患者会因各种原因导致痰液排出受限，严重者可出现呼吸衰竭，且需给予气管插管，插管后可见大量脓性痰液引出，加之ICU患者往往病情危重、病程长、机体抵抗力差，增加了口腔感染机会[1-2]，ICU的这些特点对气道护理提出了较高的要求，如果能够提高吸痰效率，可有效避免吸入性肺炎，避免过早气管插管等。可视喉镜现已被广泛用于各个医院除手术室外的其他临床工