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目的探究3种不同呼吸机撤机失败的原因及撤机效果。方法将中山市博爱医院2015-06—2015-12间重症监护室内进行呼吸机治疗的患者150例作为研究对象,按数字奇偶法随机分为3组,每组各50例,甲组应用呼吸机智能模式脱机,乙组应用医师经验脱机,丙组应用护士主导脱机,比较3组患者撤机效果与成功率。结果 3组患者撤机并发症发生率比较,甲组显著低于乙组,组间比较差异有统计学意义(P<0.05);撤机成功率比较,甲组明显优于乙组、丙组,甲组丙组组间比较差异有统计学意义(P<0.05);呼吸机相关肺炎、血清蛋白水平、机械通气时间及不良的心理因素,是导致撤机失败重要原因。结论呼吸机智能模式撤机方案相较于护士主导撤机及医师经验撤机,成功率最高,且患者并发症少,日常护理可通过对其补充能量,增强心理护理与缩短通气的时间等方式来提高撤机的成功率。
Objective To investigate the reasons for the failure of three different ventilator weaning and the weaning effect. Methods A total of 150 cases of patients undergoing ventilator therapy in intensive care unit in Pok Oi Hospital of Zhongshan City from June 2015 to June 2015 were enrolled in this study. They were randomly divided into 3 groups according to the number parity method, 50 in each group. The intelligent mode was taken offline. The application of physician experience in group B was taken offline. The application of nurse in group C was taken offline. The weaning effectiveness and success rate were compared among the three groups. Results Compared with group B, the incidence of weaning complications in group A was significantly lower than that in group B (P <0.05), and the success rate of weaning was significantly better in group A than group B and group C (P <0.05). Ventilator-associated pneumonia, serum protein, mechanical ventilation time and adverse psychological factors were the main reasons leading to the failure of weaning. Conclusions The ventilator smart-mode weaning program has the highest success rate and less patient complications than the nurse-led weaning and physician’s experience weaning. Daily care can be supplemented by energy, psychological care and shortened ventilation time To improve the success rate of weaning.