颅脑损伤患者气管切开术后人工气道湿化方法比较与护理

目的探讨颅脑损伤重症监护病房（ICU）患者在建立人工气道后的护理方法，比较观察传统人工和微泵持续湿化气道的不同效果。方法选择已使用机械通气7d以上的患者20例，随机分为观察组和对照组，每组10例。观察组使用微泵持续滴注给药．并向套管内注入低渗盐水（0．45％氯化钠溶液）湿化气道：对照组采取人工间断推注生理盐水（0．9％氯化钠溶液）100mL加安溴索4mL，并在常温下定时、间断向套管内推注生理盐水，每次2～6mL湿化气道。对比观察10d后两组患者发生肺部感染、痰痂形成、刺激性咳嗽、气道出血等并发症情况。结果观察组各种并发症发生情况均低于对照组。结论微泵持续湿化气道的效果明显优于传统间断气管内湿化方法，而且无需采用生理盐水湿化．适用于建立人工气道后的ICU患者的气道湿化。

Exploration of artificial airway nursing after tracheotomy

Objective To research the nursing of patients with craniocerebral injury in intensive care unit （ICU） after establishing artificial airway,to observe the effects of the traditional artificial airway and micropump continuous humidification trachea comparatively. Methods 20 patients with mechanism ventilation more than 7 days were selected and divided into obser- vation group and control group randomly, 10 cases in each group. Observation group was continually humidified with micropump of hypotonic saline （0.45% sodium chloride solution） ,while control group was humidified with artificial discontinuous drip of 100 mL normal saline （0.9% sodium chloride solution） with 4 mL ambroxol, meanwhile, normal saline was injected regularly and discon- tinuously at room temperature for airway humidity. Finally, to compare and observe the occurrence of pulmonary infection, forma- tion of sputum scab, irritable cough, airway bleeding and so on after 10 days between the two groups. Results The occurence rate of complications in observation group was lower than that in control group. Conclusion The effect of micropump continuous hu- midification trachea is obviously superior to the traditional discontinuous internal humidification of trachea without humidifying of nor- mal saline. This nursing method is applicable to the airway humidification for patients with artificial airway in ICU ward.