BiPAP在撤机困难患者脱机中的应用和护理

目的　探讨机械通气患者撤机困难时应用BiPAP过渡脱机的护理方法。方法　对 10例较长时间机械通气的呼吸衰竭患者 ,采用更换开窗式气管套管并堵塞开口 ,经鼻 (面 )罩BiPAP通气辅助撤机。结果　 10例患者除 1例因肾功能衰竭死亡 ,其余 9例经BiPAP通气 5～ 13d ,成功拔除气管套管 ,自主呼吸及咳嗽排痰均较好。结论　对长时间机械通气的患者 ,做好脱机前的心理护理使其保持积极的心态是顺利脱机的前提 ,保证BiPAP有效通气 ,锻炼自主排痰能力是成功撤机的关键。

Applying and Nursing of BiPAP in Patients who have Difficulty in Withdrawing from Mechanical Ventilation

Objective To identify the nursing methods of applying BiPAP in the patients who have difficulty in withdrawing from mechanical ventilation.Methods 10 patients with respiratory failure who received long-term mechanical ventilation received BiPAP nasal (mask) ventilation.Results 9 patients were removed tracheal pipe successfully after having received BiPAP ventilation for 5 to 13 days.Conclusions It was the premise of withdrawing from ventilation smoothly that the patients who received the long-term mechanical ventilation were nursed very well psychologically before withdrawing from ventilation.It was the key of withdrawing from ventilation successfully to ensure effective ventilation and clear out sputum spontaneously.