床边支气管镜在重型颅脑损伤气管切开患者护理中应用.docVIP

床边支气管镜在重型颅脑损伤气管切开患者护理中应用 　　【摘要】 目的：分析重型颅脑损伤的患者而行气管切开后在应用床边支气管镜吸痰并加以灌洗的治疗效果。方法：将重型颅脑损伤而行气管切开的患者98例随机分为观察组和对照组各49例，对照组给予常规吸痰、翻身拍背，观察组给予床边支气镜吸痰并灌洗。比较两组患者气管套管拔除时间、肺部感染控制时间、气道阻塞及出血发生率。结果：观察组气管套管拔除时间、感染控制时间均短于对照组；气道阻塞及出血发生率均低于对照组，差异均有统计学意义（P0.05 ）。结论：气管切开患者应用床边支气管镜吸痰并灌洗有效缩短气管套管拔除时间、肺部感染控制时间，减少气道阻塞及出血发生率。 　　【关键词】 床边支气管镜； 重型颅脑损伤； 气管切开 　　doi：10.14033/j.cnki.cfmr.2017.34.052 文献标识码 B 文章编号 1674-6805（2017）34-0104-03 　　Application of Bedside Bronchoscopy in the Treatment of Severe Traumatic Brain Injury with Tracheotomy/LI Caixia，XU Youfang.//Chinese and Foreign Medical Research，2017，15（34）：104-106 　　【Abstrect】 Objectives：To analyze the treatment effect of bedside bronchoscope suction and lavage on severe head injured patients after tracheotomy.Method：Ninety-eight patients with severe head injury who underwent tracheotomy were randomly divided into observation group（n=49） and control group（n=49）.Patients in control group received traditional sputum suction and those in observation group received bronchoscope suction and lavage.The time of tracheal tube removal and contral of pulmonary infection，rate of airway obstruction and bleeding were compared. Result：The time of tracheal tube removal and contral of infection，rate of airway obstruction and bleeding were lower in observation group than in control group，the differences were statistically significant（P0.05）.Conclusion：Beside bronchoscope suction and lavage for patients underwent tracheotomy can effectively reduce time of tube removal and infection contro，can reduce the rate of airway obstruction and bleeding. 　　【Key words】 Beside bronchoscopy； Severe head injury； Tracheotomy 　　First-author’s address： Dafeng Hospital of Chaoyang District in Shantou City，Shantou 515154，China 　　?B脑损伤是临床常见疾病，重型颅脑损伤（severe brain injury，SBB）患者存在不同程度的昏迷，口腔、鼻腔、咽部合并损伤出血，气道分泌物增多，呕吐物等因素导致呼吸道不通畅。故此类患者常伴随气道阻塞、呼吸衰竭的症状，对患者生命造成直接威胁[1]。并且由于患者处于长期卧床状态，咳嗽反射消失或减弱，并伴随肺部感染症状，导致患者出现呼吸道分泌物阻塞，提高呼吸道梗阻窒息、低氧血症等并发症的发生率[2-3]。为确保生命安全，临床多采用气管切开术进行紧急处理，帮助患者气道在短时间内恢复畅通，