Kiyama T, Yoshinaga T, Hayasaka S, Fujino N, Maemoto H, Matsukado Y
Department of Pulmonology, Kumamoto Chuo Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Dec;33 Suppl:141-4.
With a limited number of beds for patients undergoing medical and surgical treatment for respiratory diseases, we set aside 6 of 45 beds on one floor to be used as a respiratory care unit. During the past 5 years, 1820 patients (1225 medical and 595 surgical) were admitted to the respiratory care unit; they were treated for an average of 5.02 days. Of the patients being treated medically, 451 received mechanical ventilatory support. The majority of those patients had acute exacerbations of chronic respiratory failure due to emphysema or to sequelae of pulmonary tuberculosis. Acute respiratory distress associated with asthma or with pneumonia were also relatively common, as was the adult respiratory distress syndrome. A total of 119 patients on home oxygen therapy are being seen as out-patients, and the respiratory care unit was found to be quite useful whenever they needed intensive management. Only 148 (8.1%) of the patients admitted to the respiratory care unit died before discharge, and the ratio of cost to performance was good. The respiratory care unit was most effective in allowing for continuity of care from the onset of respiratory distress, and including exacerbations, surgical interventions, postoperative management, and out-patient care.
由于用于接受呼吸道疾病内科和外科治疗患者的床位数量有限，我们在一层的45张床位中划出6张用作呼吸护理单元。在过去5年中，1820名患者（1225名内科患者和595名外科患者）被收治入呼吸护理单元；他们平均接受治疗5.02天。在内科治疗的患者中，451名接受了机械通气支持。这些患者大多数患有因肺气肿或肺结核后遗症导致的慢性呼吸衰竭急性加重。与哮喘或肺炎相关的急性呼吸窘迫以及成人呼吸窘迫综合征也相对常见。共有119名接受家庭氧疗的患者作为门诊患者就诊，并且发现呼吸护理单元在他们需要强化治疗时非常有用。在呼吸护理单元收治的患者中，只有148名（8.1%）在出院前死亡，成本效益比良好。呼吸护理单元在实现从呼吸窘迫发作开始的连续护理方面最为有效，包括病情加重、手术干预、术后管理和门诊护理。
