ICU无创机械通气患者口渴感水平及影响因素分析
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摘要
目的探讨ICU无创机械通气患者口渴感水平及影响因素。方法应用口渴数字评分量表(NAS)对108例无创机械通气患者不同时间点的口渴感水平进行调查。结果无创机械通气患者口渴程度随着机械通气时间的延长逐渐加重(P<0.01);口渴评分6.14±1.26。机械通气时间、呼吸型态、吸入潮气量及漏气量、呼吸频率、是否首次使用无创机械通气、面罩舒适度是患者口渴感的影响因素(P<0.05,P<0.01)。结论 ICU无创机械通气患者口渴感发生率高,口渴的发生与机械通气时间、是否首次使用无创机械通气及呼吸频率、面罩匹配度等因素有关,需对患者积极实施干预,预防和减轻患者口渴程度,提高治疗依从性。
Objective To investigate the thirst level and its influencing factors in patients receiving non-invasive mechanical ventilation in ICU.Methods The thirst level of 108 patients on non-invasive mechanical ventilation therapy was investigated at various time points by using the Numeric Rating Scale(NAS).Results The thirst level in patients on non-invasive mechanical ventilation therapy progressed as mechanical ventilation went on, with the NAS score being 6.14±1.26 averagely. Mechanical ventilation time, respiratory patterns, inhaled tidal volume and air leak volume, respiratory frequency, whether being on first time non-invasive mechanical ventilation therapy or not, and face mask matching degree were significant predictors of thirst(P<0.05,P<0.01).Conclusion Thirst occurs with high frequency in patients on non-invasive mechanical ventilation therapy in ICU. The time of mechanical ventilation, respiratory patterns, inhaled tidal volume and air leak volume, whether being on first time non-invasive mechanical ventilation therapy or not, respiratory frequency, face mask matching degree are main risk factors of thirst. Measures should be taken to prevent and mitigate thirst level, and improve treatment compliance.
Objective To investigate the thirst level and its influencing factors in patients receiving non-invasive mechanical ventilation in ICU.Methods The thirst level of 108 patients on non-invasive mechanical ventilation therapy was investigated at various time points by using the Numeric Rating Scale(NAS).Results The thirst level in patients on non-invasive mechanical ventilation therapy progressed as mechanical ventilation went on, with the NAS score being 6.14±1.26 averagely. Mechanical ventilation time, respiratory patterns, inhaled tidal volume and air leak volume, respiratory frequency, whether being on first time non-invasive mechanical ventilation therapy or not, and face mask matching degree were significant predictors of thirst(P<0.05,P<0.01).Conclusion Thirst occurs with high frequency in patients on non-invasive mechanical ventilation therapy in ICU. The time of mechanical ventilation, respiratory patterns, inhaled tidal volume and air leak volume, whether being on first time non-invasive mechanical ventilation therapy or not, respiratory frequency, face mask matching degree are main risk factors of thirst. Measures should be taken to prevent and mitigate thirst level, and improve treatment compliance.
引文
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[8] Lombardo V, Vinatier I, Baillot M L, et al.How caregivers view patient comfort and what they do to improve it:a French survey[J].Ann Intensive Care,2013,3(1):19.
[9] 林榕,李红.危重症患者口渴的研究进展[J].中华护理杂志,2016,51(11):957-959.
[10] Garcia A K A, Fonseca L F, Aroni P, et al.Estrategias para o alivio da sede:reviso integrativa da literatura[J].Rev Bras Enferm,2016,69(6):1215-1222.
[11] 周复,罗治海.慢性阻塞性肺疾病炎症机制研究进展[J].现代医药卫生,2015,31(18):2787-2789.
[12] Conchon M F, Nascimento L A, Fonseca L F, et al.Perioperative thirst: an analysis from the perspective of the Symptom Management Theory[J].Rev Esc Enferm USP,2015,49(1):122-128.
[2] Kalfon P, Mimoz O, Auquier P, et al.Development and validation of a questionnaire for quantitative assessment of perceived discomforts in critically ill patients[J].Intensive Care Med,2010,36(10):1751-1758.
[3] Nelson J E, Meier D E, Oei E J, et al.Self-reported symptom experience of critically ill cancer patients receiving intensive care[J].Crit Care Med,2001,29(2):277-282.
[4] 陈俊杉,张爱琴.ICU机械通气患者口渴的研究进展[J].护理学杂志,2018,33(10):102-106.
[5] 中华医学会重症医学分会.慢性阻塞性肺疾病急性加重患者的机械通气指南(2007)[J].中国危重病急救医学,2007,19(9):513-518.
[6] Chanques G, Constantin J M, Sauter M, et al.Discomfort associated with under humdified high-flow oxygen therapy in critically ill patients[J].Intensive Care Med,2009,35(6):996-1003.
[7] Ros L, Nonoyama M, Rezaie S, et al.Psychological wellbeing,health related quality of life and memories of intensive care and a specialised weaning centre reported by survivors of prolonged mechanical ventilation[J].Nurs Crit Care,2014,30(3):145-151.
[8] Lombardo V, Vinatier I, Baillot M L, et al.How caregivers view patient comfort and what they do to improve it:a French survey[J].Ann Intensive Care,2013,3(1):19.
[9] 林榕,李红.危重症患者口渴的研究进展[J].中华护理杂志,2016,51(11):957-959.
[10] Garcia A K A, Fonseca L F, Aroni P, et al.Estrategias para o alivio da sede:reviso integrativa da literatura[J].Rev Bras Enferm,2016,69(6):1215-1222.
[11] 周复,罗治海.慢性阻塞性肺疾病炎症机制研究进展[J].现代医药卫生,2015,31(18):2787-2789.
[12] Conchon M F, Nascimento L A, Fonseca L F, et al.Perioperative thirst: an analysis from the perspective of the Symptom Management Theory[J].Rev Esc Enferm USP,2015,49(1):122-128.