神经外科重症监护患者非计划性拔管的特征分析

目的了解神经外科重症监护患者非计划性拔管的现状,分析其特征及影响因素,为进一步研究提供参考。方法应用自行设计的调查表前瞻性观察神经外科重症监护患者置管和拔管的情况,并对结果进行统计学分析。结果观察患者119例,置管337例次,总置管时间1 872.5d,非计划性拔管18例次,16例次为胃管、尿管等低危导管;13例次为自行拔管,其中10例次为有约束自行拔管。结论神经外科重症监护患者发生非计划性拔管的可能性高,约束并不能避免其发生,应从多方面控制,加强细节管理和重点患者的防护。

Clinical characteristics of unplanned extubation in neurosurgery intensive care unit

Objective To identify the characteristics and risk factors associated with unplanned extubation in neurosurgery intensive care unit(NICU) and to provide the basis for further research.Methods A prospective study was made to investigate intubation and unplanned extubation patients in NICU by using a self-designed questionnaire.Results A total of 119 cases were under observation and they had 337 tubes/catheters intubated and held in place for 1 872.5 days in total.Eighteen tubes/catheters were extubated/removed unplannedly,and 16 were low-risk nasogastric tubes and urinary catheters.Among unplanned extubation,13 tubes/catheters were extubated/removed by patients themselves,including 10 tubes/catheters being deliberately extubated/removed even under restriction. Conclusion Patients admitted to NICU have greater risk of unplanned extubation,and physical restraint of patients does not necessarily prevent it.Measures should be taken to control the occurrence of unplanned extubation.Also,detail management and key patients′ care should be reinforced.