集束化护理策略在脱机气管切开患者并发症中的应用

Application of Cluster-Based Nursing Strategy for Complications in Weaned Tracheotomy Patients

摘要: 目的：探讨集束化护理策略在脱机气管切开患者中的应用效果，评价该方案对降低气道相关并发症的临床应用价值。方法：选取2025年2月~2026年3月本院中医康复科收治的40例气管切开脱机患者，采用随机数字表法分为观察组与对照组，每组各20例。对照组实施气管切开常规护理；观察组在常规护理基础上实施集束化护理策略，构建包含气道湿化、规范吸痰、气囊精细化管理、套管及造口护理、误吸预防、动态风险评估与家属宣教的成套干预方案。对比两组患者肺部感染、痰痂堵塞套管、气道黏膜出血、气管套管移位的发生情况，统计单项并发症及总并发症发生率。结果：观察组肺部感染、气道黏膜出血发生率显著低于对照组(P < 0.05)；痰痂堵塞套管、气管套管移位两组对比差异无统计学意义(P > 0.05)；观察组气道总并发症发生率明显低于对照组。结论：对康复病房气管切开患者实施集束化护理策略，能够有效减少肺部感染、气道黏膜出血，降低气道总并发症发生率，保障人工气道安全，促进患者康复。

Abstract: Objective: To explore the application effect of cluster-based nursing strategy among weaned tracheotomy patients, and evaluate its clinical value in reducing airway-related complications. Methods: A total of 40 weaned tracheotomy patients admitted to the Department of Traditional Chinese Medicine Rehabilitation of our hospital from February 2025 to March 2026 were selected. Patients were divided into the observation group and the control group by random number table, with 20 cases in each group. The control group received routine nursing care for tracheotomy. The observation group was intervened with a cluster-based nursing strategy on the basis of routine nursing. The complete intervention protocol consisted of airway humidification, standardized sputum suction, refined cuff pressure management, cannula and stoma care, aspiration prevention, dynamic risk assessment and family-member health education. The incidence of pulmonary infection, cannula obstruction by sputum crust, airway mucosal bleeding and tracheal cannula displacement were compared between the two groups. The incidences of individual complications and total complications were statistically analyzed. Results: The incidences of pulmonary infection and airway mucosal bleeding in the observation group were significantly lower than those in the control group (P < 0.05). There were no significant differences in cannula obstruction by sputum crust and tracheal cannula displacement between the two groups (P > 0.05). The total incidence of airway complications in the observation group was markedly lower than that in the control group. Conclusion: For weaned tracheotomy patients in rehabilitation wards, a cluster-based nursing strategy can effectively reduce pulmonary infection and airway mucosal bleeding, decrease the total incidence of airway complications, guarantee the safety of artificial airway and promote patients’ rehabilitation.