摘要
目的探究吸痰深度对老年卧床人工气道患者吸痰有效性与安全性的影响,从而为临床老年卧床人工气道患者吸痰提供理论依据。方法选取2018年10月至2020年1月重症医学科(ICU)人工气道患者106例为研究对象,通过抽签方法分为3组:A组:35例,采用深部吸痰;B组:35例,采用浅部吸痰;C组:36例,采用改良吸痰。对比3组患者护理期间指脉血氧饱和度(SpO2)、肺部听诊时间、吸痰间隔时间、心率(HR)、平均动脉压(MAP)、刺激性咳嗽、气管黏膜损伤、胃内容物返流情况以及肺部痰鸣音变化情况。结果A组、B组、C组患者吸痰后即刻(T0)、1 min(T1)、3 min(T3)、5 min(T5)、10 min(T10)与吸痰前(T前)相比,SpO2升高,HR下降、MAP下降,其中T5与T10同T前比较差异有统计学意义(P<0.05);C组患者T5、T10时SpO2大于A组,HR、MAP小于A组、B组,差异有统计学意义(P<0.05);C组与A组、B组相比,其肺部听诊时间较少,吸痰间隔时间增加,差异有统计学意义(P<0.05);与B组相比,A组肺部听诊时间、吸痰间隔时间均增加,差异有统计学意义(P<0.05);B组、C组并发症发生率低于A组,差异有统计学意义(P<0.05);C组肺部痰鸣音评分高于A组、B组,差异有统计学意义(P<0.05)。结论深部吸痰对老年卧床人工气道患者吸痰期间刺激性较大,浅部吸痰虽然刺激性小,但吸痰量较少,增加了吸痰操作频率,而改良吸痰方法可兼顾吸痰安全性与有效性,且能够延长吸痰间隔时间,减少护理人员工作量,对患者痰鸣音改善效果更明显,有重要的应用价值。
Objective To investigate the effects sputum suction depth on the effectivity and safety of sputum suction in elderly patients with artificial airway,so as to provide a theoretical basis for clinical sputum suction for the elderly patients with artificial airway.Methods A total of 106 patients with artificial airway who were treated in ICU of our hospital from October 2018 to January 2020 were enrolled in the study,who were divided into three groups by lottery.The patients in group A(n=35)were treated by deep sputum suction,and the patients in group B(n=35)were treated by superficial sputum suction,and the patients in group C(n=36)were treated by modified sputum suction.The pulse oxygen saturation(SpO2),lung auscultation time,sputum suction interval time,heart rate(HR),mean arterial pressure(MAP),irritating cough,tracheal mucosa injury,gastric content return Flow and the changes of lung sputum sounds were observed and compared among the three groups.Results After sputum suction,the SpO2 levels immediately after sputum suction(T0),1min(T1),3min(T3),5min(T5),10min(T10)in the three groups were increased,however,the HR and MAP were decreased,in which there were significant differences between those at T5,T10 and before T(P<0.05).The SpO2 levels at T5,T10 in group C were significantly higher than those in group A,but the HR and MAP were significantly lower than those in group A and group B(P<0.05).As compared with those in group A and group B,the lung auscultation time and increased sputum suction interval time in group C were significantly increased(P<0.05).Moreover the incidence rate of complications in groups B and group C was significantly lower than that in group A(P<0.05),and the lung sputum sound scores in group C were significantly higher than those in group A and group B(P<0.05).Conclusion The improved sputum suction method can improve the effectivity and safety of sputum suction in elderly patients with artificial airway,which can extend the sputum suction interval time,reduce the workload of nursing staff,and improve the sputum sound of patients obviously,therefor,it is of important application value.
作者
王加梅
张静
赵蕾
WANG Jiamei;ZHANG Jing;ZHAO Lei(Taishan Hospital,Shandong,Tai’an 271000,China;不详)
出处
《河北医药》
CAS
2021年第12期1879-1882,共4页
Hebei Medical Journal
关键词
吸痰深度
老年卧床患者
人工气道
吸痰有效性
安全性
depth of sputum suction
elderly bedridden patients
artificial airway
effectiveness of sputum suction
safety
