振动排痰机在全麻开胸手术后应用.doc

振动排痰机在全麻开胸手术后的应用张丽平? 江宾 蒋燕 张宣英 (廖佳四川省肿瘤医院胸外二科? 四川成都? 610041)【中图分类号】R197.39??? 【文献标识码】A? 【文章编号】1672-5085（2010）34-0058-02【摘要】目的? 研究观察G2000型振动振动排痰机—Hema在胸部物理治疗中应用的优势、可行性及护理。方法? 随机将240例开胸术后病例分成治疗组和对照组，120例治疗组使用Hama进行胸部叩击振动体位引流治疗和护理，120例对照组指导排痰技巧或传统叩背排痰护理，两组均密切观察病人临床应用效果。结果? 治疗组与对照组的生命体征、血气结果、排痰效果、肺部感染发生率、病人的舒适度及护士的操作感受均有显著性差异(P0.05)。结论　G2000型振动排痰机—Hema可促进排痰；可避免因人工手法不熟练给病人带来的痛苦，并减轻护理人员工作强度，有利于提高护理工作质量，值得临床推广应用。 【关键词】? 振动排痰机?? 排痰? 开胸手术后?? 临床应用 Application of Rock Sputum Ejection Machine for Post-thoracotomy Patients? ZHANG Li-ping，JIANG Bin，JIANG Yan，ZHANG Xuan-Ying， Sichuan Cancer Hospital，Chengdu，610041，China 【Abstract】 Objective: To investigate the advantages , possibility and care of using Rock Sputum ejection machine, Hema, in chest physical therapy．Methods: 240 Post-thoracotomy Patients were randomly divided into treatment group and control group, 120 patients in the control group, r olling and knocking the back plus moist inhalation while applying chest physic al therapy, 120 patients in the therapeutic,using rock sputum ejection machine,?? under the same condition. two groups Patients are closely observed clinical effect. Results There was significant difference Between the two groups in vital signs, blood gas results, the effects of sputum ejection, the incidence of lung infection, the patients comfort and f nurses feelings about the operation (P0.05). Conclusions Rock sputum ejection machine can obtain satisfactory?? effects,prevent suffer resulted from non- skilled rolling and knocking the back? plus moist inhalation and nursing, and obviously decrease the load of nursing．? 【Key words】 rock sputum ejection machine?? sputum ejection?? Post-thoracotomy?? cinical application??????? 全麻开胸手术时间长、创伤大，术后肺功能影响明显，黏液分泌紊乱和清除障碍，加上气管插管侵入性操作及麻醉和术后过程中误吸口腔和胃肠道内容物，如不及时清除容易使分泌物、误吸物积聚堵塞气管，诱发肺部感染和肺不张，严重者甚至发生低氧血症。有研究者观察到麻醉期间以及手术后气管纤毛运动速率下降，纤毛清除率降低[1]。临床上全身麻醉开胸病人术后有明显的呼吸道分泌物增多、黏稠，加之病人术后疼痛、咳嗽无力，因而容易并发肺不张和肺炎。协助病人有效排痰是预防术后肺部并发症的主要措施之一，胸外科术后如何有效预防和控制肺部感染，是治疗和护理的重要内容，也是反映医疗和护理质量的重要方