郑瑞 李琳婧

【摘要】 目的：探討密闭式吸痰联合纤维支气管镜在急性呼吸窘迫综合征（ARDS）机械通气患者中应用综合护理的应用效果。方法：选取接受密闭式吸痰联合纤维支气管镜治疗的ARDS机械通气患者120例，按随机数字表法将其分为对照组与观察组，各60例。对照组接受常规护理，观察组接受综合护理。比较两组干预前后心率（HR）、血氧饱和度（SpO2）、氧合指数（PaO2/FiO2）、机械通气时间、呼吸机相关性肺炎发生率。结果：观察组干预后SpO2、PaO2/FiO2均高于对照组，HR低于对照组，差异均有统计学意义（P<0.05）。观察组干预后机械通气时间短于对照组，呼吸机相关性肺炎发生率低于对照组，差异均有统计学意义（P<0.05）。结论：综合护理可有效提升密闭式吸痰联合纤维支气管镜ARDS机械通气患者血氧饱和度，缩短机械通气时间，减少呼吸机相关性肺炎的发生。

【关键词】 急性呼吸窘迫综合征 密闭式吸痰 纤维支气管镜 机械通气 护理

doi：10.14033/j.cnki.cfmr.2019.28.044 文献标识码 B 文章编号 1674-6805（2019）28-0-03

Nursing Analysis of Closed Sputum Suction Combined with Fiberoptic Bronchoscopy in Patients with ARDS Mechanical Ventilation/ZHENG Rui， LI Linjing. //Chinese and Foreign Medical Research， 2019， 17（28）： -108

[Abstract] Objective： To investigate the application effect of closed sputum suction combined with fiberoptic bronchoscopy in the comprehensive nursing of patients with acute respiratory distress syndrome （ARDS） mechanical ventilation. Method： A total of 120 ARDS patients with mechanical ventilation treated with closed sputum suction combined with fiberoptic bronchoscopy were selected and divided into the control group and the observation group according to the random number table method， with 60 cases in each group. The control group received routine nursing， while the observation group received comprehensive nursing. The heart rate （HR）， blood oxygen saturation （SpO2） and oxygenation index （PaO2/FiO2）， mechanical ventilation time and incidence of ventilator-associated pneumonia were compared between the two groups before and after intervention. Result： After intervention， SpO2， PaO2/FiO2 in the observation group were higher than those in the control group， and HR was lower than that in the control group， the differences were statistically significant （P<0.05）. After intervention， mechanical ventilation time in the observation group was shorter than that in the control group， and the incidence of ventilator-associated pneumonia was lower than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： Comprehensive nursing can effectively improve the blood oxygen saturation of patients with ARDS mechanical ventilation with closed sputum suction combined with fiberoptic bronchoscopy， shorten the mechanical ventilation time of patients and reduce the incidence of ventilator-associated pneumonia.

[Key words] Acute respiratory distress syndrome Closed sputum suction Fiberoptic bronchoscopy Mechanical ventilation Nursing

First-authors address： First Affiliated Hospital of Xiamen University， Xiamen 361003， China

急性呼吸窘迫综合征（ARDS）属于临床常见呼吸急症，其发病速度快，病情通常较为复杂，早期难以对疾病进行有效确诊，具有较高病死率[1]。目前临床上在对该疾病进行治疗时，所应用的方法主要为机械通气[2]。通过清除机体气道分泌物，可使机械通气患者保持气道畅通，使通气情况得以改善，同时对于呼吸机相关性肺炎的发生可起到预防作用。有报道指出，通过实施高效气道分泌物清除，可使ARDS患者的疾病预后得到改善[3]。密闭式吸痰联合纤维支气管镜可有效改善ARDS患者的临床症状。而在为ARDS患者实施气道分泌物清除的过程中，护理干预的开展可保障分泌物清除效果，对于治疗的实施具有积极意义[4]。综合护理属于新型护理模式，其可将护理程序系统化，由此使疾病护理更具有针对性，保障护理干预效果[5]。……