摘要
目的:探讨听诊结合吸痰管刺激吸痰法对机械通气患者动脉血气的影响。方法:将62例患者随机分为观察组与对照组各31例。对照组患者有明显痰鸣音时或呼吸机气道峰压升高报警立即给予吸痰,观察组患者采用听诊结合吸痰管刺激吸痰法。比较两组患者吸痰前、吸痰结束时、吸痰后5 min动脉血气变化;吸痰前后血压、心率变化;平均吸痰量、机械通气时间、住院天数、住院费用、呼吸机相关性肺炎发生情况。结果:观察组患者吸痰前后PaO2、SaO2均处于高值,影响不明显,PaCO2较对照组患者下降明显,对照组患者吸痰前后PaO2、SaO2波动明显;两组患者吸痰前后血压、心率变化比较差异无统计学意义(P>0.05);平均吸痰量、机械通气时间、住院天数、住院费用、呼吸机相关性肺炎发生情况比较差异有统计学意义(P<0.01)。结论:为机械通气患者实施听诊结合吸痰管刺激吸痰能有效提高血氧含量,预防因气道阻塞时间长致机体缺氧造成的各种并发症,减少呼吸道黏膜损伤。
Objective： To explore the effect of stimulated sputum suctioning with suction tube by auscultation detection on ABG of the patients with mechanical ventilation.Methods： 62 patients were randomly divided into observation group and control group（31 patients for each group）.In the control group,the sputum suctioning was immediately conducted when the patients were found to have distinct wheezing sound or the alarm was heard when the peak airway pressure was increased;in the observation group the patients were treated with stimulated sputum suctioning with suction tube by auscultation detection.The change of blood gas were compared between the two groups before sputum suctioning,at the end of sputum suctioning and after sputum suctioning for 5 minutes;the blood pressure and change of heart rate,mean suction volume,duration of mechanical ventilation,hospitalization days and expenses and the incidence of ventilator-associated pneumonia were also compared between the two groups before sputum suctioning.Results： The value of PaO2,SaO2 were in high level and the effect was not obvious before and after sputum suctioning in the observation group,but the value of PaCO2 decreased significantly compared with the control group;the fluctuation of PaO2 and SaO2 was evident before and after sputum suctioning in the control group and the differences in the comparison of blood pressure and the change of heart rate were not statistically significant between the two groups before and after sputum suctioning;there were statistically significant differences in the comparison of the average suction volume,duration of mechanical ventilation time,hospitalization days and expenses and the incidence of ventilator-associated pneumonia between the two groups（P0.01）.Conclusion： The application of stimulated sputum suctioning with suction tube by auscultation detection to the patients with mechanical ventilation can effectively increase the oxygen content of blood,prevent various complications induced by hypoxia because of a long time airway obstruction and reduce the injury of respiratory mucosa.
关键词
听诊
吸痰管
机械通气
动脉血气
Auscultation
Suction tube
Mechanical ventilation
Arterial blood gas
