序贯性机械通气治疗ALIARDS护理探讨.docVIP

序贯性机械通气治疗ALIARDS护理探讨 　　[摘要] 目的 探讨序贯性机械通气治疗急性肺损伤/急性呼吸窘迫综合征护理措施。 方法 选择2014年6月～2015年8月本院呼吸内科住院序贯性机械通气治疗ALI/ARDS患者40例为研究对象，采取心理护理、预防感染护理、气道护理、鼻饲饮食护理等综合护理措施，把握机械通气最佳的序贯时机。记录患者成功脱机的病例数，以及患者上机前、上机后4h、拔管前、无创通气4h的血气分析、pH、心率、呼吸频率等指标。 结果 40例患者经序贯性机械通气治疗及护理，35例临床治愈，顺利脱机，5例死亡。与上机前比较，上机后患者的血气、pH、心率以及呼吸频率等指标均明显优于对照组，差异有统计学意义（P0.05）；与拔管前比较，无创通气4h后患者的血气、pH、心率以及呼吸均明显优于把关前，差异有统计学意义（P0.05）。 结论 积极的护理方法有效实施非常重要，是保证有创-无创序贯性机械性通气治疗ALI/ARDS效果的基础条件，有利于取得较满意的临床治疗效果，提示拔管环节处理得当能为后期的撤机打下良好的基础，降低VAP发生率，缩短MV时间及住院时间，降低患者住院费用，减轻患者经济负担。 　　[关键词] 机械通气；ALI/ARDS；护理；成功脱机 　　[中图分类号] R563.8 [文献标识码] B [文章编号] 2095-0616（2016）01-100-04 　　[Abstract] Objective To study the nursing methods of sequential mechanical ventilation in the treatment of acute lung injury and acute respiratory distress syndrome. Methods 40 patients with ALI/ARDS，who were treated with sequential mechanical ventilation and were hospitalized in respiratory medicine department of our hospital from June 2014 to August 2015，were selected as the research objects， and were adopted by comprehensive nursing methods of psychological nursing， infection prevention nursing， airway nursing， nasal feeding nursing， grasped the best sequential opportunity of mechanical ventilation.To record the cases of successful offline，the index of blood gas analysis，pH，heart rate，respiratory rate before mechanical ventilation，4h after mechanical ventilation， before tube drawing，4h noninvasive ventilation of patients. Results After sequential mechanical ventilation treatment and nursing on 40 patients，there were 35 cases clinical cured with successful offline，and 5 cases dead.The index of blood gas analysis，pH，heart rate，respiratory rate after mechanical ventilation was better than which before mechanical ventilation，and which in study group was better than which in control group，the differences was statically significant（P0.05），which 4h after mechanical ventilation was obviously better than which before tube drawing， the differences was statically significant （P0.05