苏进秀

[摘要] 目的 分析肺癌術后使用呼吸机患者试脱机中最佳护理干预时机。 方法 选取2015年3月～2017年11月于本院实施肺癌术的50例患者作为研究对象，所有患者术后均使用呼吸机通气治疗，按照试脱机护理干预方式的不同将患者分成两组，开始试脱机时实施护理的患者作为观察组，开始自主呼吸实验时实施护理的患者作为常规组，对比分析两组患者的首次拔管成功率、24 h内再次插管率以及拔管后的不良事件。 结果 观察组患者首次拔管成功率为96%，常规组首次拔管成功率为68%，差异有统计学意义（P<0.05）；观察组患者24 h内再次插管率为4%，常规组患者24 h内再次插管率为12%，差异无统计学意义（P>0.05）；观察组患者拔管后不良事件发生率为4%，常规组患者拔管后不良事件的发生率为24%，差异有统计学意义（P<0.05）。 结论 肺癌术后行呼吸机通气治疗患者，于开始试脱机时实施护理为最佳的干预时机，可有效提高首次拔管的成功率，降低二次拔管率，同时减少脱机后的不良反应，在肺癌术后行呼吸机治疗患者的试脱机中，应于开始试脱机时实施护理干预。

[关键词] 肺癌术；呼吸机；试脱机；护理干预

[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701（2018）12-0157-03

Analysis of the best nursing intervention time in readiness for weaning from the ventilator of patients with ventilator after lung cancer surgery

SU Jinxiu

Outpatient Department，Zaozhuang Mining Group Central Hospital，Zaozhuang 277800，China

[Abstract] Objective To analyze the best nursing intervention time in readiness for weaning from the ventilator of patients with ventilator after lung cancer surgery. Methods 50 patients who underwent lung cancer surgery in our hospital from March 2015 to November 2017 were selected as the study subjects. All patients were treated with ventilator therapy after surgery. Patients were divided into two groups according to the intervention method of readiness for weaning from the ventilator. The patients who were treated with nursing at the time of readiness for weaning from the ventilator were taken as observation group， and the patients who were treated with nursing during spontaneous breathing experiment were taken as the conventional group. The success rate of first extubation， reintubation rate within 24 hours and adverse events between two groups were compared and analyzed. Results The successful rate of first extubation was 96% in the observation group and 68% in the conventional group， and the difference were statistically significant（P<0.05）. The rate of reintubation within 24 hours in the observation group was 4%. And the rate of reintubation within 24 hours in the conventional group was 12%. There was no statistically significant difference between the two groups（P>0.05）. The incidence of adverse events after extubation in the observation group and the conventional group was 4% and 24%. There was a statistically significant difference between the two groups（P<0.05）. Conclusion Intervention carried out at the time of readiness for weaning from the ventilator is the best intervention time for patients undergoing respirator ventilation after lung cancer surgery， which can effectively improve the success rate of first extubation， reduce the rate of secondary extubation and adverse reactions. In readiness for weaning from the ventilator of patients undergoing respirator therapy after lung cancer， care intervention should be implemented at the time of readiness for weaning from the ventilator.

[Key words] Lung cancer surgery； Ventilator； Readiness for weaning from the ventilator； Nursing intervention

肺癌是临床中较为常见的癌症类型之一，近几年，随着医疗技术的发展，肺癌的治疗有效率明显提升[1]。肺癌术后患者部分肺组织被切除，肺部功能受损，往往需要呼吸机辅助呼吸进行治疗，呼吸机通气治疗作为一种过渡性的治疗手段，对于保障患者的生命具有重要意义，在多年的临床护理中发现，不同时机实施护理干预所产生的试脱机结果是不同的[2]。为了明确肺癌术后使用呼吸机患者试脱机中最佳护理干预时机，我院选取了2015年3月～2017年11月实施肺癌术的50例患者进行研究分析，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年3月～2017年11月于本院实施肺癌术的50例患者作为研究对象，所有患者术后均使用呼吸机通气治疗，按照试脱机护理干预方式的不同将患者分成两组，开始试脱机时实施护理的患者作为观察组，开始自主呼吸实验时实施护理的患者作为常规组，每组25例。……