不同护理干预对开胸术后肺部并发症的预防效果研究

目的探讨传统拍背咳痰与振动排痰机对胸部手术后肺部并发症的预防、排痰效果及改善呼吸功能的作用。方法选择120例胸部手术患者,按随机原则分为实验组与对照组,各60例,对2组患者术后发生低氧血症、肺不张、需纤维支气管镜(纤支镜)介入吸痰的情况,以及术后6h与术后48h的动脉血气结果进行对比分析。同时观察并记录2组病例的排痰感受。结果2组患者发生低氧血症、肺不张、需纤支镜介入吸痰情况,实验组均明显少于对照组(P<0.01);观察2组病例的排痰感受,实验组感觉舒适与对照组相比有显著差异;对照组感到剧痛而不愿排痰,与实验组相比相差亦显著;术后48h的PaO2、PaCO2与排痰前即术后6h比较均有显著性差异(P<0.01),pH值两者前后均无统计学意义。但实验组术后48h与术后6h的PaO2、PaCO2差值与对照组术后48h与术后6h的差值相比较,有非常显著性差异。结论使用振动排痰机行胸廓振动法对开胸术后肺部并发症的预防与治疗起了积极有效的作用。

Study on the prevention effect of different nursing methods on pulmonary complications for patients underwent thoracic operation

Objective To study the prevention effect,the sputum excretion effect and the amelioration of respiratory function of vibratory sputum ejection apparatus(VIBSEA)and traditional sputum ejection apparatus on pulmonary complications for patients underwent thoracic operation.Methods 120 patients underwent thoracic operation were selected and randomly divided into the control group(60 cases)and the experiment group(60 cases).Hypoxemia,pulmonary atelectasis,and sputum ejection by fiberoptic bronchoscopy to allure sputum were compared in both groups.The arterial blood gas was measured at 6 hours and 48 hours after the operation,and the feeling of sputum excretion also observed and recorded in the two groups.Results The complications,such as hypoxemia,pulmonary atelectasis and sputum ejection by fiberoptic bronchoscopy were significantly less in the experiment group.The cases of comfortable feeling in the control group were less than that in the experiment group,but the cases of pain feeling in the control group were more than that in the experiment group(P<0.01).There were significant differences in PaO_2 and PaCO_2(P<0.01),and no statistical meaning in pH of PaO_2 and PaCO_2 at 48 hours and 6 hours after the operation for the patients with the two methods.But there were significant differences in the differences of PaO_2 and PaCO_2 at 48 hours and 6 hours after the operation between the two groups.Conclusions The use of VIBSEA is safe,well-tolerated,comfort and effective in preventing pulmonary complications for patients underwent the thoracic operation.