本文選題：氣管切開術(shù) + 氣管套管　； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研制一種安全、便捷、舒適的氣管套管固定帶,并評(píng)估其臨床應(yīng)用效果。方法:調(diào)查分析常用氣管套管固定帶的種類及臨床應(yīng)用現(xiàn)狀,設(shè)計(jì)并自制一種改良?xì)夤芴坠芄潭◣?其特征為并行雙帶+可拆卸連接件,通過并行雙帶的設(shè)計(jì),增加固定帶與患者皮膚的接觸面積,提高佩戴舒適度;通過可拆卸連接件的設(shè)計(jì)達(dá)到無需松開全部的固定帶即可完成輔料更換、固定帶清潔的工作,最大程度降低了由于清潔固定帶或提起固定帶內(nèi)襯保護(hù)墊等操作引起的脫管風(fēng)險(xiǎn)。選擇2016年6月-2017年3月在山西醫(yī)科大學(xué)第一醫(yī)院耳鼻咽喉頭頸外科、神經(jīng)外科、神經(jīng)內(nèi)科、ICU科行氣管切開術(shù)后的住院患者150例,隨機(jī)分為3組,每組各50例,分別給予選取臨床上常用的兩種氣管套管固定帶,傳統(tǒng)醫(yī)用窄繃帶(對(duì)照組A)、欣瑞德?導(dǎo)管固定裝置(對(duì)照組B)與本研究設(shè)計(jì)的氣管套管固定帶(實(shí)驗(yàn)組)進(jìn)行對(duì)比,觀察并記錄術(shù)后3天、7天、14天各個(gè)時(shí)點(diǎn)患者頸部皮膚損害的情況、患者舒適度、護(hù)理人員更換固定帶、喉墊的難易程度、時(shí)間、頻率以及患者意外脫管發(fā)生率等指標(biāo)。結(jié)果:1.研制改良并行雙帶+可拆卸連接件氣管套管固定帶,并獲得實(shí)用新型專利(專利號(hào)201620440991X)。2.參加試驗(yàn)的150例患者均完成試驗(yàn),無失訪和提前退出者,三組患者在年齡、性別、臨床診斷、APACHEⅡ評(píng)分、Branden評(píng)分等方面比較,無統(tǒng)計(jì)學(xué)差異(P0.05),具有可比性。3.皮膚損害發(fā)生率比較,對(duì)照組A為22%,對(duì)照組B為14%,實(shí)驗(yàn)組為4%,三組患者差異有統(tǒng)計(jì)學(xué)意義(P0.05),組間比較,對(duì)照組A皮損率高于對(duì)照組B,對(duì)照組B高于實(shí)驗(yàn)組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);患者頸部皮膚舒適度VAS評(píng)分比較,術(shù)后3天,對(duì)照組A患者VAS評(píng)分為(8.56±0.58),對(duì)照組B患者VAS評(píng)分為(7.36±0.69),實(shí)驗(yàn)組患者VAS評(píng)分為(3.98±0.84);術(shù)后7天,對(duì)照組A患者VAS評(píng)分為(7.48±0.65),對(duì)照組B患者VAS評(píng)分為(6.4±0.76),實(shí)驗(yàn)組患者VAS評(píng)分為(3.1±0.76);術(shù)后14天,對(duì)照組A患者VAS評(píng)分為(6.58±0.64),對(duì)照組B患者VAS評(píng)分為(5.74±0.75),實(shí)驗(yàn)組患者VAS評(píng)分為(2.4±0.64),三組患者術(shù)后3天、7天、14天患者佩戴舒適度差異均有統(tǒng)計(jì)學(xué)意義(P0.05),組間比較,各時(shí)間點(diǎn)實(shí)驗(yàn)組舒適度均高于對(duì)照組A、對(duì)照組B,對(duì)照組B高于對(duì)照組A,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);給予患者使用不同固定帶,護(hù)理人員更換難易程度VAS評(píng)分比較,對(duì)照組A為(7.06±1.11),對(duì)照組B為(6.22±1.02),實(shí)驗(yàn)組為(3.32±0.87),三組差異有統(tǒng)計(jì)學(xué)意義(P0.05),組間比較,實(shí)驗(yàn)組比對(duì)照組A、對(duì)照組B的固定帶更換較容易,對(duì)照組B比對(duì)照組A更換較容易,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);更換喉墊難易程度VAS評(píng)分比較,實(shí)驗(yàn)組為(3.22±0.86),對(duì)照組A為(6.60±0.73),對(duì)照組B為(6.46±0.84),實(shí)驗(yàn)組與對(duì)照組A、對(duì)照組B均有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組A和對(duì)照組B之間差異無統(tǒng)計(jì)學(xué)差異(P0.05);發(fā)生意外脫管情況比較,三組之間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.改良的氣管套管固定帶,符含固定帶操作需求,安全、方便、有效。2.通過比較三組氣管套管固定帶的臨床應(yīng)用效果,發(fā)現(xiàn)本研究設(shè)計(jì)的氣管套管固定帶能顯著減輕患者皮膚損害發(fā)生率、顯著提高患者佩戴舒適度;護(hù)理人員更換改良固定帶較為容易,耗時(shí)較短,且被污染時(shí),可清潔、消毒,從而減少更換次數(shù),減輕護(hù)理人員工作量,降低患者痛苦;喉墊更換較容易,且用時(shí)較短;套管脫出風(fēng)險(xiǎn)較低,更適用于氣管切開患者,值得臨床推廣、應(yīng)用。
[Abstract]:Objective: to develop a safe, convenient and comfortable tracheal tube fixed belt and evaluate its clinical application effect. Methods: To investigate and analyze the types and clinical application of common tracheal cannula, and to design and self-made a modified tracheal tube fixed belt, which is characterized by a parallel double band and detachable connector, and increased by parallel double band design. Fix the contact area with the skin of the patient to improve the wear comfort; through the design of the detachable connector to complete the replacement of the excipient without having to unlock all the fixed belts, the fixed belt cleaning work, the maximum reduction of the removal risk caused by the operation of the clean fixed belt or the fixed belt lining protection pad. Choose 2016 In March -2017 -2017 March, 150 hospitalized patients in the first hospital of Shanxi Medical University, otolaryngology head and neck surgery, Department of Neurosurgery, neurology, and ICU section were randomly divided into groups of 50 cases each, respectively, which were given two commonly used endotracheal tube fixation bands, traditional medical narrow bandage (control group A), and Xin Reed? Catheter The fixation device (control group B) was compared with the tracheal cannula fixed band (experimental group) designed by this study. The cases of cervical skin damage at 3 days, 7 days and 14 days after the operation were observed and recorded. The comfort degree of the patients, the replacement of the fixed belt, the difficulty of the larynx pad, the time, frequency and the incidence of accidental removal of the tube. Fruit: 1. to develop and improve the parallel double band + detachable connecting parts of the trachea cannula, and obtain a new patent (patent number 201620440991X).2. to participate in the test, all the patients completed the test. No loss of visits and early withdrawal, three groups of patients in age, sex, clinical diagnosis, APACHE II score, Branden score, and so on, no statistical difference. P0.05, compared with the ratio of.3. skin damage, the control group A was 22%, the control group B was 14%, the experimental group was 4%, the three groups were statistically significant (P0.05), compared with the control group, the A skin loss rate was higher than the control group B, the control group B was higher than the experimental group, the difference was statistically significant (P0.05); the neck skin comfort of the patients was compared to the VAS score. 3 days after operation, the VAS score of the control group A was (8.56 + 0.58), the VAS score of the control group was (7.36 + 0.69), the VAS score of the experimental group was (3.98 + 0.84), and the VAS score of the control group A patients was (7.48 + 0.65), and the VAS score of the control group of B patients was (6.4 + 0.76), and the VAS score of the experimental group was (3.1 + 0.58). The score was (6.58 + 0.64). The VAS score of the control group was (5.74 + 0.75) and the VAS score of the experimental group was (2.4 + 0.64). The difference of comfort degree between the three groups of patients at 3 days, 7 days and 14 days was statistically significant (P0.05). The comparison between the groups was higher than that of the control group A, the control group was B, and the control group B was higher than the control group A, the difference was all There was statistical significance (P0.05); the patients were given different fixed bands, and the VAS scores of the nurses were compared, the control group A was (7.06 + 1.11), the control group B was (6.22 + 1.02), the experimental group was (3.32 + 0.87), the three groups were statistically significant (P0.05), the experimental group was A and the control group was more easy to replace the B in the control group. The change of B in group A was more easy than that of the control group (P0.05); the experimental group was (3.22 + 0.86), the control group was (6.60 + 0.73), the control group was (6.60 + 0.73), and the control group B was (6.46 + 0.84), the experimental group and the control group were A, and the control group B had statistical significance (P0.05). There was no statistical difference between the control group A and the control group B. The difference (P0.05); there was no significant difference between the three groups (P0.05). Conclusion: 1. improved tracheal cannula fixation belt, which contains the fixed belt operation demand, is safe and convenient, and effective.2. can be significantly reduced by comparing the clinical effect of three groups of tracheal cannula fixed belts. The incidence of skin damage in light patients is significantly improved, and the comfort degree of the patients is significantly improved; the nurses are easier to replace the modified fixed belt, shorter time consuming, and can be cleaned and sterilized when they are polluted, thus reducing the number of replacement, reducing the workload of the nursing staff and reducing the pain of the patients; the replacement of the larynx pad is easier and shorter; the risk of casing removal is lower and more suitable. For tracheotomy patients, it is worthy of clinical promotion and application.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R472

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳捷晗;李艷娟;曹紅;田翠蘭;;新型對(duì)扣PVC氣管套管固定帶的研制及臨床應(yīng)用[J];護(hù)理研究;2016年26期

2 侯建紅;宋娟;;中空式氣管套管固定帶的設(shè)計(jì)與應(yīng)用[J];中華現(xiàn)代護(hù)理雜志;2016年22期

3 景峰;戚雯雯;梁婧;吳蓓雯;;氣管切開固定帶的制作與臨床應(yīng)用[J];上海護(hù)理;2016年01期

4 劉利敏;趙招弟;詹慧;莊端端;金潤(rùn)女;;四種氣管切開套管固定方法效果的比較[J];解放軍護(hù)理雜志;2015年21期

5 王麗娟;李武平;;2種材料在氣管切開導(dǎo)管固定中的效果比較[J];檢驗(yàn)醫(yī)學(xué)與臨床;2015年18期

6 吳永紅;;舒適護(hù)理在ICU氣管切開患者管理中的應(yīng)用[J];齊魯護(hù)理雜志;2015年06期

7 陳巧靈;馬燕蘭;亢君;李忠海;;改良?xì)夤芴坠芄潭◣R床應(yīng)用研究[J];中國急救復(fù)蘇與災(zāi)害醫(yī)學(xué)雜志;2015年03期

8 劉聰;霍春暖;薛云娜;;新型氣管套管固定帶在氣管切開病人中的應(yīng)用[J];護(hù)理研究;2015年08期

9 鄭黎;;壓脈帶在ICU氣切套管固定中的應(yīng)用[J];全科護(hù)理;2015年02期

10 俞志茹;鐘建榮;羅建華;劉秋華;徐桂芳;邱琳;應(yīng)保健;;改良?xì)夤芮虚_寸帶在危重癥氣管切開患者中的臨床應(yīng)用[J];贛南醫(yī)學(xué)院學(xué)報(bào);2014年06期

相關(guān)碩士學(xué)位論文 前2條

1 徐萍;硅膠內(nèi)襯套材料與小腿皮膚界面摩擦特性研究[D];西南交通大學(xué);2014年

2 毛永軍;危重病人氣管切開術(shù)若干問題探討[D];浙江大學(xué);2011年

，

本文編號(hào)：2004865