摘要
目的 研究个性化吸痰护理方案用于危重症人工气道患者的临床效果。方法 选取2023年1月～2024年5月于本院就诊的98例危重症人工气道患者，根据护理方法的不同将其随机分为两组，其中对照组(n=49)采用常规吸痰护理措施，观察组(n=49)采用个性化吸痰护理方案。记录并对比两组患者护理前后的动脉血氧分压(oxy-gen partial pressure，PaO2)、动脉血二氧化碳分压(pressure of arterialcarbon dioxide，PaCO2)、动脉血氧饱和度(arterial oxygen saturation，SaO2)等血气分析指标。记录两组患者的吸痰间隔时间、日均吸痰次数、吸痰管清洁度、机械通气时间、人工气道留置时间及住院时间等临床指标。统计两组患者的不良反应发生情况。调查两组患者的护理满意度，包括健康教育、主动服务意识、专项操作技术、吸痰护理等4个方面。结果 相较于对照组，观察组患者的PaO2、SaO2水平更高，PaCO2水平更低（P＜0.05）。相较于对照组，观察组患者的吸痰间隔时间、吸痰管清洁度更高，日均吸痰次数、机械通气时间、人工气道留置时间、住院时间更低（P＜0.05）。相较于对照组（28.57%），观察组的不良反应总发生率（10.20%）更低（P＜0.05）。相较于对照组，观察组的健康教育、主动服务意识、专项操作技术、吸痰护理等方面评分及满意度总分更高（P＜0.05）。结论 将个性化吸痰护理方案应用于危重症人工气道患者的临床护理中，可有效提高机体的血气，并减少吸痰次数，缩短住院时间，促进患者康复，且不良反应较少，具有较高的护理满意度及临床应用价值。
关键词： 人工气道；动脉血氧分压；不良反应；吸痰；护理满意度
Abstract
Objective To study the clinical effect of personalized sputum aspiration nursing scheme for patients with critical artificial airway. Methods Ninety-eight critically ill patients with artificial airway treated in our hospital from January 2023 to May 2024 were randomly divided into two groups according to different nursing methods. The control group (n=49) received conventional sputum aspiration nursing measures, and the observation group (n=49) received personalized sputum aspiration nursing plans. oxy-gen partial pressure (PaO2) and pressure of arterialcarbon dioxide (PAO2) were recorded and compared between the two groups before and after care. arterial oxygen saturation (SaO2), arterial oxygen saturation (PaCO2) and other blood gas analysis indicators. Clinical indexes such as sputum aspiration interval, average daily number of sputum aspiration, cleanliness of sputum aspiration tube, mechanical ventilation time, artificial airway retention time and hospital stay were recorded in the two groups. The incidence of adverse reactions in the two groups was analyzed. To investigate the nursing satisfaction of the two groups of patients, including health education, active service consciousness, special operation technology, sputum suction nursing and other 4 aspects. Results Compared with the control group, the PaO2 and SaO2 levels in the observation group were higher, and the PaCO2 levels were lower (P < 0.05). Compared with control group, observation group had higher sputum aspiration interval time, sputum aspiration tube cleanliness, lower average daily sputum aspiration times, mechanical ventilation time, artificial airway retention time and hospital stay (P < 0.05). Compared with the control group (28.57%), the total incidence of adverse reactions in the observation group (10.20%) was lower (P < 0.05). Compared with the control group, the scores of health education, active service consciousness, special operation technology, sputum aspiration care and the total score of satisfaction in the observation group were higher (P < 0.05). Conclusion The application of personalized sputum aspiration nursing scheme in the clinical nursing of critically ill artificial airway patients can effectively improve the body's blood gas, reduce the number of sputum aspiration, shorten the hospital stay, promote the recovery of patients, and have less adverse reactions, with higher nursing satisfaction and clinical application value.
Key words： Artificial airway; Arterial partial pressure of oxygen; Adverse reactions; Aspirate sputum; Nursing satisfaction
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