重症患者气管插管气囊压力管理的持续质量改进效果研究

Study on Continuous Quality Improvement Effect of Tracheal Intubation Balloon Pressure Management in Critically Ill Patients

摘要: 目的：探讨持续质量改进(CQI)护理干预在气管插管患者气囊压力管理中的应用效果，为优化重症患者护理策略提供科学依据。方法：采用随机数表法选取2023年4月至2023年11月收治的70例气管插管重症患者，随机分为观察组和对照组，每组35例。观察组实施基于CQI的气囊压力管理护理，对照组实施常规护理。比较两组患者的气囊压力控制合格率、动脉血氧分压(PaO₂)、循环功能(心率、收缩压、舒张压)及气道相关并发症发生率。结果：观察组气囊压力控制合格率显著高于对照组(94.29% vs. 71.43%, P < 0.05)。观察组PaO₂ (93.12 ± 2.56 mmHg)显著高于对照组(89.45 ± 5.12 mmHg, P < 0.05)。在循环功能方面，观察组心率、收缩压及舒张压均显著优于对照组(P < 0.05)。观察组无严重并发症发生，对照组出现1例气道黏膜损伤事件。结论：CQI护理干预显著提高了气管插管患者的气囊压力管理效果，改善了呼吸和循环功能，降低了气道相关并发症的发生率，具有重要的临床应用价值。

Abstract: Objective: To investigate the effect of continuous quality improvement (CQI) nursing intervention in balloon pressure management of tracheal intubation patients, and to provide scientific basis for optimizing nursing strategies for critical patients. Methods: 70 patients with severe tracheal intubation admitted from April 2023 to November 2023 were randomly divided into observation group and control group, with 35 cases in each group. The observation group received CQI-based balloon pressure management nursing, and the control group received routine nursing. The pass rate of balloon pressure control, arterial partial oxygen pressure (PaO₂), circulatory function (heart rate, systolic blood pressure, diastolic blood pressure) and the rate of airway related complications were compared between the two groups. Results: The qualified rate of airbag pressure control in observation group was significantly higher than that in control group (94.29% vs. 71.43%, P < 0.05). The PaO₂ in observation group (93.12 ± 2.56 mmHg) was significantly higher than that in control group (89.45 ± 5.12 mmHg, P < 0.05). In terms of circulatory function, the heart rate, systolic blood pressure and diastolic blood pressure of observation group were significantly better than those of control group (P < 0.05). No serious complications occurred in the observation group, and 1 case of airway mucosal injury occurred in the control group. Conclusion: CQI nursing intervention can significantly improve the effect of balloon pressure management in patients with tracheal intubation, improve respiratory and circulatory functions, and reduce the incidence of airway related complications, which has important clinical application value.