气管插管拔除后肺部感染相关因素分析及护理干预

目的探讨气管插管拔除后肺部感染相关因素及护理措施。方法调查112例ICU接受气管插管的患者在拔除气管插管后,出现肺部感染是否与年龄、性别、低蛋白血症、胸腹部创伤性疼痛、咳痰无力、长时间卧床、意识状态有关,将调查数据进行统计学分析,找出相关因素,给予护理干预措施。结果 112例气管插管拔除患者,发生肺部感染51例,占45.54%,无肺部感染61例,占54.46%;其中发生肺部感染的患者中有21.57%（11/51）因肺部感染加重而再次置管;肺部感染与低蛋白血症、胸腹部创伤性疼痛、咳痰无力、长时间卧床、意识状态有关（P〈0.05）,而与年龄和性别无关（P〉0.05）。结论对于气管插管拔出后的患者继续给予营养支持,适当镇痛剂应用,进行有效排痰,对意识不清患者加强鼻胃管管理和口腔护理,缩短卧床时间,能减少肺部感染的发生率,从而提高拔管的成功率,降低再置管的风险。

Investigation and analysis of related factors of pulmonary infection following extubation and nursing intervention

Objective To explore the related factors of pulmonary infection following the extubation and nursing intervention. Methods The clinical data of 112 patients undergoing endotracheal intubation in ICU were enrolled in this study.The incidence of pulmonary infection after the extubation and its relationship with age,sex,hypoalbuminemia,wound pain in chest and abdomen,expectoration weakness,long time in bed and state of consciousness were analyzed statistically. The nursing intervention measures were improved according to the related factors. Results 51 in 112 cases were with pulmonary infection after the extubation with an incidence of 45. 54%,and 21. 57% of them underwent the re-catheterization because of the aggravated pulmonary infection. There was association between pulmonary infection with hypoproteinemia,wound pain in chest and abdomen,expectoration weakness,long time in bed and state of consciousness（ P〈0. 05）,no with age and sex（P〈0. 05）. Conclusion For the patients with endotracheal intubation,the nutritional support,proper application of analgesics,effective expectoration,and carefully nasogastric tube administration and oral care can shorten the time in bed,reduce the incidence of pulmonary infection,improve the success rate of extubation,and reduce the risk of re-catheterization.