成人哮喘史患者围手术期气道管理方案的构建及应用研究

doi:10.3761/j.issn.0254-1769.2026.18.005

摘要/Abstract

摘要：

目的构建成人哮喘史患者围手术期气道管理方案并探究其应用效果，为围手术期哮喘预防与管理提供参考依据。方法 2025年9月，通过文献研究、专家函询等形成该方案。采用便利抽样法，选取浙江省某三级甲等医院的165例哮喘史患者作为研究对象，其中2025年10—12月纳入的80例患者为试验组，2024年10—12月纳入的85例患者为对照组，试验组实施构建的气道管理方案，对照组实施常规气道管理。比较两组干预前后血管活性药物使用率、气道痉挛发生率、哮喘急性发作发生率、气管拔管时间、麻醉后监护病房停留时间、院前等待时间、术前等待时间、患者住院时间的差异。结果最终试验组纳入80例，对照组纳入83例。试验组气道痉挛发生率为15.00%，低于对照组的32.53%；哮喘急性发作发生率为11.25%，低于对照组的22.89%，差异均具有统计学意义（P=0.009、0.049）；试验组术前等待时间为1.0（1.0，2.0）d，低于对照组的2.0（1.0，3.0）d，差异具有统计学意义（P=0.010）。两组其他指标的比较，差异无统计学意义（P>0.05）。结论构建的气道管理方案具有科学性，可满足成人哮喘史患者围手术期护理需求，实施该方案能降低患者气道痉挛和哮喘急性发作的风险，缩短术前等待时间，改善围手术期预后。

关键词: 哮喘史, 围手术期, 气道管理, 循证方案, 护理

Abstract:

Objective To develop a perioperative airway management program for adult patients with a history of asthma and explore its application effects，aiming to provide a reference for the prevention and management of perioperative asthma. Methods In September 2025，the protocol was developed through literature review and expert consultation. Using convenience sampling，165 patients with a history of asthma were selected from a tertiary hospital in Zhejiang Province. Among them，80 patients enrolled from October to December 2025 served as an experimental group，and 85 patients enrolled from October to December 2024 served as a control group. The experimental group received an evidence-based airway management protocol，while the control group received conventional airway management. The following outcomes were compared between the 2 groups before and after the intervention，including vasoactive drug use rate，incidence of airway spasm and acute asthma exacerbation，tracheal extubation time，length of stay in the post-anesthesia care unit，pre-hospital waiting time，preoperative waiting time，and hospital length of stay. Results Ultimately，80 patients were included in the experimental group and 83 patients in the control group. The incidence of airway spasm in the experimental group（15.00%） was lower than that in the control group（32.53%），and the incidence of acute asthma exacerbation（11.25%） was lower than that in the control group（22.89%），with statistically significant differences（P=0.009，0.049）. The preoperative waiting time in the experimental group was 1.0（1.0，2.0） d，which was shorter than 2.0（1.0，3.0） d in the control group，with statistically significant differences（P=0.010）. There were no statistically significant differences between the 2 groups in the other sets of indicators（P>0.05）. Conclusion The airway management protocol developed in this study is scientifically sound，and it can meet the perioperative nursing needs of patients with a history of asthma，reduce the risk of asthma airway spasm and acute attack，and shorten preoperative waiting time，promoting their recovery.

Key words: History of Asthma, Perioperative Period, Airway Management, Evidence-Based Protocol, Nursing Care

袁华娣, 韩娜菲, 高丽燕, 贺红, 吴小燕, 吴竖光, 严敏. 成人哮喘史患者围手术期气道管理方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(18): 2486-2494.

YUAN Huadi, HAN Nafei, GAO Liyan, HE Hong, WU Xiaoyan, WU Shuguang, YAN Min. Construction and application of a perioperative airway management protocol for adult patients with a history of asthma[J]. Chinese Journal of Nursing, 2026, 61(18): 2486-2494.

图/表 4

表1 成人哮喘患者围手术期气道管理方案

Table 1 The perioperative airway management in adult patients with asthma

表2 两组一般资料的比较[例（百分比，%）]

Table 2 Comparison of general data between the 2 groups[case（percentage，%）]

表3 两组主要结局指标的比较

Table 3 Comparison of primary indicators between the 2 groups of patients

表4 两组次要结局指标的比较[d，M（P25，P75）]

Table 4 Comparison of secondary indicators between the 2 groups of patients[d，M（P25，P75）]

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