ICU人工气道吸痰最佳护理实践标准研究现状及探讨

目的对ICU患者进行人工气道吸痰的最佳护理实践方式进行临床研究。方法选取2009年2月至2011年2月在我院ICU病房接受治疗的患者100例,其中50例患者采用传统的人工气道吸痰方式进行吸痰,作为对照组;剩下的50例患者在传统人工气道吸痰的方式上进行改进,作为观察组,统计两组患者的护理效果和出现并发症的人数,使用SPSS13.0统计学软件进行χ2检验,α=0.05。结果观察组患者中,38例患者有效,8例患者显效,4例患者无效;对照组患者中,25例患者有效,11例患者显效,14例患者无效。P<0.05,具有统计学意义。结论对人工气道吸痰方式进行优化,可有效的提高ICU患者吸痰的有效率,具有重要的临床治疗意义。     

浅层吸痰法对人工气道患者气道黏膜影响的研究

目的探讨人工气道不同吸痰方法对患者的影响。方法将2010年1月～2011年8月在本院ICU行人工气道患者,根据建立人工气道的日期进行分组,单号建立为观察组,运用浅层吸痰法,双号建立为对照组,运用常规吸痰法。通过两组吸痰方法的比较,观察两组患者吸痰操作时的患者状态及气道损伤情况。将两组患者得出的数据进行统计学分析。结果两组患者的研究指标有显著差异;常规吸痰法造成患者气道黏膜损伤的例数较多,吸痰管插入长度较深,对气管产生的刺激较大,引起患者明显的烦躁及呛咳较多。两种吸痰方法在患者的刺激、气道损伤等方面,观察组优于对照组（P〈0.05、P〈0.01）。结论浅层吸痰法可以避免或降低对建立人工气道患者的气道损伤,减少对患者的刺激,提高人工气道疗效,减低并发症,有效地提高患者的人工气道护理质量,是建立了人工气道患者的一种较为理想的、人性化的吸痰方法,值得临床推广及应用。     

ICU人工气道病人的呼吸道护理

目的分析ICU人工气道病人护理的几个常见问题及护理对策。方法通过对783例人工气道患者的人工气道的固定、气囊的管理、呼吸机的使用和参数的调节、保持气道温、湿度、吸痰的护理、加强口鼻咽部的护理等。结果有4例痰痂形成(0.5%),意外脱管3例(0.3%),口腔溃疡8例(1%),无1例因护理操作方法不当导致病人死亡。结论对建立人工气道的患者应高度重视导管的固定、气囊的管理、气道的温湿度和吸痰、口鼻咽部的有效护理、呼吸机的正确使用。它们是预防和减少肺部并发症的有效方法。     

浅析神经外科危重患者人工气道的护理及感控措施

目的探讨神经外科危重患者人工气道的护理措施。方法回顾总结2009年1月至2011年3月神经外科危重患者建立人工气道患者98例护理措施。结果护理措施包括全面监护、湿化吸痰、吸痰的方法、切口的护理、预防感染等。结论人工气道是保证气道开放，防止气道不通畅或被阻塞的主要措施，针对性地对气道的加温、加湿，清除气道分泌物，严格无菌操作规程，降低医源性气道感染的机会，在保障呼吸道通畅。     

浅谈脑出血人工气道深部吸痰和浅部吸痰的区别

吸痰是临床最常见的护理工作之一,特别是对于人工气道、肺部感染而气道分泌物较多的患者,吸痰已经不仅仅只是一种护理,更是一种非常重要的治疗手段.本文主要探讨脑出血人工气道深部吸痰和浅部吸痰的区别以及优缺点,希望可以寻找到一种较为安全有效的吸痰方法,帮助患者更好的治疗,减少并发症的发生,提高患者的舒适度,促使患者病情的恢复.     

循证护理在重型颅脑损伤并发急性呼吸窘迫综合征患者机械通气气道湿化和吸痰中的应用

目的探讨循证护理在重型颅脑损伤并ARDS患者机械通气湿化和吸痰中的应用。方法选择人住我院ICU的重型颅脑损伤并ARDS建立人工气道机械通气患者78例,按随机数字表法分为观察组41例和对照组37例。对照组患者只给予机械通气常规护理,观察组患者在气道湿化和吸痰上实施循证护理。比较两组患者并发症发生率和吸痰后SpO2水平。结果观察组患者并发症的发生率明显低于对照组（P〈0．05）;观察组患者吸痰结束时、吸痰后1min、吸痰后5min血氧水平明显高于对照组（P〈0．05）。结论循证护理在重型颅脑损伤并ARDS患者机械通气湿化和吸痰中的应用可以有效减少机械通气患者并发症的发生率,有效减少SpO2的下降幅度。     

封闭式吸痰与开放式吸痰的应用比较

目的探讨封闭式吸痰对神经外科人工气道患者临床应用的效果。神经外科疾病发病急,进展快,并发症多,死亡率高,常伴有不同程度的呼吸障碍,需依靠人工气道及机械辅助通气才能维持呼吸,因患者病情危重,咳嗽、吞咽反射减弱或消失,呼吸道分泌物不能及时有效的排出,加之长期卧床极易发生肺部感染,故加强呼吸道护理至关重要。方法选取神经外科69例人工气道患者,随机分组,进行对封闭式吸痰与传统的开放式吸痰的临床应用观察比较。结果封闭式吸痰可预防传统式吸痰所造成的低氧血症、心肌缺氧、心律失常、心搏骤停、感染、不良心理反应,操作方法简便易行,优越性显著,具有较高的使用依从性,是一种科学、合理、安全的新型吸痰技术。     

呼吸道吸痰中并发症的预防与护理

呼吸道吸痰中并发症的预防与护理０５００１１河北医产院附属第四医院侯俭使用人工呼吸机通气的患者，呼吸道护理尤为重要，应在气道吸痰中密切观察、预测、预防并发症的发生。呼吸道常见的并发症有感染、气道粘膜出血、肺不张等肺部合并症。我院ＩＣＵ通过对人工通气患者...     

开展品管圈活动对ICU护士人工气道吸痰护理质量的影响

目的探讨品管圈活动在规范ICU护士人工气道吸痰护理质量持续改进中的效果。方法2012年lO月起成立品管圈小组,确立以“规范ICU护士人工气道吸痰护理质量”为活动主题,针对ICU护士人工气道吸痰的情况进行调查,针对吸痰不规范的主要问题,制定预期目标,实施质量改进对策,并评价改进效果。结果品管圈活动开展前后比较,护士对人工气道吸痰相关知识知晓率由75．65％上升到99．5％;规范吸痰正确率由85．60％上升到96．80％,经统计学处理,差异有统计学意义（P〈0．05;P〈0．01）。结论开展品管圈活动能够提高ICU护士人工气道吸痰护理质量,降低并发症发生率。     

人工鼻联合密闭式吸痰对人工气道湿化的效果观察

目的观察人工鼻联合密闭式吸痰对建立人工气道机械通气患者湿化效果的影响。方法将人住ICU机械通气超过48h的患者1J4例按随机数字表法分为观察组（人工鼻联合密闭式吸痰组）59例和对照组（开放性吸痰管联合加温加湿器组）55例,对两组人工气道湿化的效果、应用人工气道时间、应用机械通气时间、呼吸机相关性肺炎（VAP）的发生率、住ICU的时间、住院病死率等方面进行比较。结果观察组患者痰液湿化效果好的病例多于对照组,导管痰痂病例少于对照组;应用人工气道时间两组病例比较无差异;观察组在应用机械通气时间和住ICU的时间上均少于对照组,观察组VAP发生率低于对照组;病死率两组病例比较无差异;观察组无湿化意外出现,对照组发生呛水8例。结论机械通气患者使用人工鼻联合密闭式吸痰进行气道管理,能够满足加热加湿吸入气体的要求,有利于改善气道湿化效果,且能降低VAP发生率,缩短机械通气时间。     

Readmissions for treatment for alcoholism

First admissions and readmissions for alcoholism have risen steeply in recent decades. This study looked at readmission histories for four cohorts of alcoholics first admitted to inpatient psychiatric treatment in 1967-68, 1973, 1977 or 1979. Over the twelve years the first cohort was observed, alcoholics on average spent 254 days in treatment and had 2.14 alcohol-related readmissions. However the distributions were very skewed: 50% stayed less than 92 days and 45.6% had no readmissions at all. All four cohorts yielded similar results over comparable time periods and all showed markedly skewed distributions reflecting the diversity of readmission histories among alcoholics. Policy decisions about alcoholism inpatient treatment must take account of this diversity.     

Projections for insulin treatment for diabetics

The evolution of insulin treatment of diabetes has dramatically changed the natural course of this disease. Modern recombinant DNA technology has brought about many new insulin analogues with improved pharmacokinetics, resulting in better glycemic control. In addition, improved insulin delivery systems, such as insulin pumps and pens, have been introduced to provide convenience and to enhance patient compliance. Efforts are currently being devoted to developing noninvasive insulin formulations, such as oral and pulmonary insulin. A number of products are at different stages of clinical trials. Meanwhile, the quest for a permanent cure for diabetes continues. The frontier of diabetes research has gone through a period of substantial expansion, with the emergence of new areas that include gene therapy, islet cell transplantation and diabetic vaccine. Technological breakthroughs, such as recombinant DNA, nanotechnology, microarray-aided genomics and proteomics, will provide more profound insights into the pathogenesis, and the immunological and biological basis of diabetes. Our growing knowledge in these areas will ultimately contribute to the discovery of preventive methods against or a cure for this disease.     

Control of craving for methamphetamine: development of scales for dependence and search for medicines for treatment]

Methamphetamine dependence presents a serious problem not only for patients but also for society. Medical treatment has mainly targeted psychotic symptoms such as hallucination and delusion, and ignored the symptoms of craving, which are the major cause of dependence. Therefore, the risk of lapse into methamphetamine reuse remains very high. Although development of both medicines and programs for treatment of craving is needed, progress has been hampered by the lack of appropriate scales for assessing the severity of dependence and craving. On the other hand, recent breakthroughs in genomic sciences and molecular medicine have made it possible to investigate the molecular mechanisms underlying craving in animals. This paper reviews studies on the development of scales for assessing the severity of methamphetamine dependence and craving, together with recent data on candidate medicines for craving treatment in animals. The reliability and validity of the revised Addiction Severity Index -Japanese version (ASI-J) was confirmed after its administration to 100 drug abuse patients. The Craving Index was also newly developed, and its validity for prediction of relapse was confirmed. In animal experiments, fluoxetine, a selective serotonin reuptake inhibitor, was recognized as a candidate medicine for treatment of methamphetamine dependence.