摘要
目的研究不同的吸痰方式对应用机械通气危重症哮喘患者呼吸功能的影响。方法2007年1月至2008年4月收治的43例应用机械通气治疗的重症哮喘患者,应用前后自身对照的方法分别进行密闭式气管内吸痰(close endotracheal suction,CS)和开放式气管内吸痰(open endotracheal suction,OS)。观察患者在不同吸痰方式下,吸痰前后的pH、动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、血氧饱和度的(SaO2)、潮气量(Vt)、呼吸道峰压(Ppeak)、呼吸道平台压(Pplat)及呼吸频率(BF)的变化。结果应用OS后患者的PaO2、SaO2、Vt均较吸痰前显著降低(P<0.05),而PaCO2、Ppeak、Pplat及BF均较吸痰前明显升高(P<0.05);而应用CS后,患者的pH、PaO2、SaO2、Vt、PaCO2、Ppeak、Pplat及BF较吸痰前无明显变化(P>0.05)。结论应用机械通气的重症哮喘患者使用CS能较好的维持机体氧合状态,保持呼吸参数及呼吸道压力的相对稳定,是重症哮喘患者机械通气治疗时的较为安全有效的气管内吸痰方式。
Objective To study the effects of different endotracheal suction techniques on the respiratory function in patients with sever asthma requiring mechanical ventilation. Methods Fortythree patients with sever asthma requiring mechanical ventilation from Jan. 2007 to Apr. 2008 were randomly divided into group A and group B. Group A was given open suction（OS） after close suction（CS） and group B was given CS after OS. The patients＇ pH, partial pressure of arterial oxygen （PaO2）, partial pressure of arterial carbon dioxide （PaCO2）, arterial oxygenation （SaO2）, tidal volume（Vt）,peak airway pressure（Ppeak）,plat airway pressure（Pplat） and respiratory rate（BF） were compared under different endotracheal suction techniques. Results Patients＇ PaOz ,SaOz and Vt decreased significantly and PaCOz, Ppeak, Pplat and BF increased significantly after OS（P〈0. 05）. Patients＇ pH, PaO2, SaO2, Vt PaCO2, Ppeak,Pplat and BF showed no significant change after CS（P：〉 0.05）. Conclusion The patients＇ oxygenation status, respiratory parameters, airway pressure maintain relatively stable in mechanical ventilation after CS. It is a safe and effective endotracheal suction techniques for mechanical ventilation patient with sever asthma.
出处
《解放军护理杂志》
2009年第14期10-12,共3页
Nursing Journal of Chinese People's Liberation Army
关键词
气管内吸痰
重症哮喘
机械通气
呼吸功能
endotracheal suction
severe asthma
mechanical Ventilation
respiratory function
