Chen Limin, Liu Ruihong, Shen Biyu, Wang Lingling, Cui Zhiming, Xu Guanhua
Department of Nursing, the Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China (Chen LM, Liu RH, Shen BY); Department of Spinal Surgery, the Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China (Wang LL, Cui ZM, Xu GH). Corresponding author: Xu Guanhua, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Sep;29(9):836-839. doi: 10.3760/cma.j.issn.2095-4352.2017.09.014.
To evaluate the effect of a new type of fixation tape for tracheal catheter in intensive care patients.
A purposive sampling study was conducted. Ninety patients experienced oral tracheal intubation for mechanical ventilation, and admitted to respiratory intensive care unit (ICU) of the Second Affiliated Hospital of Nantong University from November 2015 to February 2017 were enrolled. All the patients were randomly (random number) divided into the control group and the observation group with 45 patients in each group. The patients in control group was treated with the traditional medical adhesive tape and fixation belt to fix endotracheal tube, while the patients in observation group was treated with a new type of tracheal catheter fixation tape. The fixation effect, skin complication rate, patient's comfort level, nursing workload and satisfaction were evaluated in both groups.
There were 6 patients with mild displacement, 2 patients with moderate displacement and 1 patient with severe displacement in the control group, while there was no catheter displacement or detachment occurred in the observation group, and the difference between the two groups was statistically significant (χ = 2.944, P = 0.003). In the control group, there were 39 patients with facial skin redness, 6 patients with facial skin damage, 36 patients with neck skin redness, and 2 patients with neck skin damage. In the observation group, there were no facial skin complications and only 2 patients with neck skin redness, and the skin complication rate was significantly higher than that of the control group (facial skin: Z = 9.173, P = 0.000; neck skin: Z = 7.549, P = 0.000). Compared with the control group, the patients' comfort levels were significantly elevated in the observation group (the intolerance patients: 9 vs. 24, the extreme discomfort patients: 4 vs. 8, Z = 3.695, P = 0.000). The total changing times of the fixation belt and operating time for each change in the observation group were significantly decreased as compared with those of control group [changing times of the fixation belt (times): 1.89±0.77 vs. 3.86±1.18, operating time for each change (minutes): 10.31±1.47 vs. 15.78±1.89, both P < 0.01]. Nursing satisfaction in the observation group was significantly higher than that of the control group (100% vs. 33.3%, P < 0.01).
The new fixation tape for tracheal catheter could significantly reduce the catheter displacement and detachment rate, and decrease the incidence of facial skin injury. It is easy to learn and worth to generalize clinically.
评估一种新型气管导管固定胶带在重症监护患者中的应用效果。
采用目的抽样研究。选取2015年11月至2017年2月在南通大学第二附属医院呼吸重症监护病房（ICU）行口气管插管机械通气的90例患者。所有患者通过随机数字表法随机分为对照组和观察组，每组45例。对照组采用传统医用胶带和固定带固定气管导管，观察组采用新型气管导管固定胶带。评估两组的固定效果、皮肤并发症发生率、患者舒适度、护理工作量及满意度。
对照组有6例轻度移位、2例中度移位、1例重度移位，观察组无导管移位或脱出，两组差异有统计学意义（χ = 2.944，P = 0.003）。对照组有39例面部皮肤发红、6例面部皮肤损伤、36例颈部皮肤发红、2例颈部皮肤损伤。观察组无面部皮肤并发症，仅2例颈部皮肤发红，皮肤并发症发生率显著低于对照组（面部皮肤：Z = 9.173，P = 0.000；颈部皮肤：Z = 7.549，P = 0.000）。与对照组相比，观察组患者舒适度显著提高（不耐受患者：9例对24例，极度不适患者：4例对8例，Z = 3.695，P = 0.000）。观察组固定带总更换次数及每次更换操作时间均显著少于对照组[固定带更换次数（次）：1.89±0.77对3.86±1.18，每次更换操作时间（分钟）：10.31±1.47对15.78±1.8,9，均P < 0.01]。观察组护理满意度显著高于对照组（100%对33.3%，P < 0.01）。
新型气管导管固定胶带可显著降低导管移位和脱出率，并减少面部皮肤损伤的发生率。其操作简单，值得临床推广。
