摘要
目的:观察危重患者吸痰前气管导管内滴注生理盐水对组织氧代谢的危害。方法:接受冠状动脉旁路移植术后入住心血管重症监护病房42例,年龄35~76岁,男26例,女16例。38例(90.5%)为首次行冠状动脉旁路移植术,4例(9.5%)为再次行冠状动脉旁路移植术。患者血流动力学状态稳定,心率60~120/min,平均动脉压60~110 mmHg,混合静脉血氧饱和度(SvO_(2))50%以上;经口建立人工气道气管插管(导管内径7.0~8.0 mm)。患者分为滴注生理盐水(NS)组18例,未滴注生理盐水组(non-NS)24例。结果:变量是混合静脉血氧饱和度基线,因变量是SvO_(2)最低点。协方差分析统计结果F=8.460,df=1.320,P=0.007,NS组患者SvO_(2)最低点明显低于non-NS组。NS组患者降低幅度-3%~-24%,SvO_(2)最低36%。non-NS组降低幅度0~-17%,SvO_(2)最低为48%。两组间恢复基线时间用不等变量t检验,t=2.079;df=18.709;P=0.050。NS组患者SvO_(2)恢复基线时间明显慢于Non-NS组,平均延长3.8 min。结论:危重患者吸痰操作,吸痰前不滴注NS患者的氧代谢状态较滴注NS患者效果好。
Objective:To describe the damage effects of instillation of normal saline into an endotracheal tube before suctioning on mixed venous oxygen saturation in critically patients.Methods:42 patients of cardiovascular intensive care unit after arteria coronaria bypass transplantation were tested,the age was 35-76 yrs,male 26 and female 16.38 cases(90.5%)were first treated with arteria coronaria bypass transplantation,4(9.5%)were second.The hemodynamic states were stable,the heart rates were 60-120 bm,the average blood pressure were 60-110mmHg,SvO_(2) were above 50%.The artificial trachea tubes were inserted through oral(the inner diameter was 700-8.0 mm).The cases were divided two groups,instillation of normal saline group 18(NS)and non group24(non-NS).Results:The variable was base line of SvO_(2),the dependent variable was the minimum of SvO_(2),the covariance analysis was F=8.460,df=1.320,P=0.007.The minimum of SvO_(2) in NS group was obviously lower than that in non-NS group.The decrease range in NS was-3%~-24%,the minimum of SvO_(2) was 36%.The decrease range in non-NS was 0~-17%,the minimum of SvO_(2) was 48%.The recovering base line times of two groups were tested by unequal T test,t=2.079;df=18.709;P=0.050。The time of NS was obviously slower than that of non-NS,the average was 3.8 min.Conclusion:Endotracheal suctioning in critically patients can damage oxygen metabolism whether using normal saline or not.
作者
常雁军
罗晓梅
杨秀玲
CHANG Yan-jun;LUO Xiao-mei;YANG Xiu-ling(Medical Department,PLA 307 Hospital,Beijing 100071,China)
出处
《灾害医学与救援（电子版）》
2014年第3期152-154,共3页
Disaster Medicine and Rescue(Electronic Edition)
