胡健 程芳 聂凌云 江莹莹 陈希兰

【摘要】 目的：探究濕度管控护理模式在神经外科重症患者人工气道中的应用效果。方法：选取2019年1月-2020年1月于本院就诊的100例神经外科重症人工气道患者为研究对象，按照随机数字表法将其分为对照组（采用常规护理）和观察组（采用湿度管控护理模式），各50例。比较两组的气道湿化效果、吸痰前后的SaO2、RR及HR、肺部感染发生率、人工气道堵管率、治愈率、住院时间、并发症发生率及家属满意率。结果：干预24、48、72 h后，观察组的气道湿化效果均优于对照组，差异均有统计学意义（P<0.05）。观察组的肺部感染总发生率、人工气道堵管率及并发症发生率均低于对照组，治愈率及家属满意率均高于对照组，住院时间短于对照组，差异均有统计学意义（P<0.05）。吸痰后，观察组的SaO2高于对照组，RR及HR均低于对照组，差异均有统计学意义（P<0.05）。结论：湿度管控护理模式在神经外科重症患者人工气道中的应用效果较好，可有效降低并发症发生率，在本类患者中的应用价值较高。

【关键词】 湿度管控护理模式 神经外科 重症患者 人工气道

Study on the Application of Humidity Control Nursing Mode in the Critical Patients with Artificial Airway in Department of Neurosurgery/HU Jian， CHENG Fang， NIE Lingyun， JIANG Yingying， CHEN Xilan. //Medical Innovation of China， 2021， 18（05）： 088-092

[Abstract] Objective： To investigate the application effect of humidity control nursing mode in the critical patients with artificial airway in department of neurosurgery. Method： A total of 100 patients with severe artificial airway in the neurosurgery department admitted to our hospital from January 2019 to January 2020 were selected as the research objects， according to the random number table method， they were divided into the control group （conventional nursing） and the observation group （humidity control nursing）， 50 cases in each group. The airway humidification effect， SaO2， RR and HR before and after sputum aspiration， pulmonary infection rates， artificial airway blockage rates， cure rates， length of hospitalized， complications rates and satisfaction rates of family members of two groups were compared. Result： 24， 48 and 72 h after intervention， the airway humidification effect of observation group were better than those of control group， the differences were statistical significance （P<0.05）. The total incidence of pulmonary infection， the artificial airway blockage rate and the incidence of complications were lower than those in the control group， the cure rate and the satisfaction rate of family members were higher than those in the control group， the length of hospital stay was significantly shorter than that in the control group， the differences were statistical significance （P<0.05）. After sputum aspiration， SaO2 in the observation group was higher than that in the control group， while RR and HR were lower than those in the control group， the differences were statistical significance （P<0.05）. Conclusion： The application effect of humidity control nursing mode in the critical patients with artificial airway in department of neurosurgery is better， it can effectively control the complications rates， so its application value in these patients is higher.

[Key words] Humidity control nursing mode Department of neurosurgery Critical patients Artificial airway

First-authors address： Jiujiang First Peoples Hospital， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.05.023

神经外科重症患者中较多患者需采用人工气道进行治疗，其是有效保证气体交换的方式，而本类治疗方式对患者的正常黏膜湿化功能造成不良影响较多，导致气道黏膜的继发性损伤[1-2]，表现出干燥、受损，呼吸道分泌物不易咳出等情况，肺部感染等发生率也显著提高[3-4]，因此对人工气道患者进行气道湿化处理的研究多见。本研究就湿度管控护理模式在神经外科重症患者人工气道中的应用效果进行探究与观察，现報道如下。

1 资料与方法

1.1 一般资料 选取2019年1月-2020年1月于本院就诊的100例神经外科重症人工气道患者为研究对象。纳入标准：18～75岁;颅脑损伤、脑血管意外、颅内感染、颅内压增高等导致患者昏迷;经格拉斯哥昏迷评分（GCS）评估，评分≤8分。排除标准：合并呼吸系统疾病;合并其他器官功能不全;发病（创伤）前存在感染。……