机械通气患者行可视化吸痰的可行性研究

发布时间：2018-11-11 15:40

【摘要】：目的：吸痰是一种常见的临床操作,由于其操作的盲目性并发症较多。最近,本项目组成员自主研发了一种可视化吸痰仪,这项研究的目的是评估机械通气患者行可视化吸痰实验的可行性及安全性,并探讨其临床价值。方法：选取2014年2月至6月于重庆医科大学附属第一医院呼吸内科重症监护室(RICU)行机械通气治疗的患者20例,将符合纳入标准的受试者随机分成可视化吸痰组(Visual Suction, VS)与密闭式吸痰组(Closed Suction, CS)行吸痰实验。可视化吸痰仪(Visual Sputum Suction System, VSSS)由一根超微型光纤(Outer Diameter, OD= 0.813mm)插入二腔吸痰管组成。评估两组患者的基本情况、吸痰中不同时刻HR、MAP和Sp02变化、不良事件发生率及光纤直视下黏膜损伤程度。结果：密闭式吸痰前后心肺参数无明显改变(P=0.14,P=0.33,P=0.08, respectively),可视化吸痰仪吸痰对SpO2、HR和MAP产生影响(P＜0.01, P=0.04, P0.01, respectively),但其多在3 min恢复基线水平(P=0.13, P=0.55, P=0.78, respectively),且吸痰后5 min时Sp02值高于传统密闭式吸痰法(P0.01);VS较传统CS法相比,可减少患者每日吸痰次数(P0.01)；在实时引导下,VS可减少吸痰所致的气道黏膜损伤及出血。结论：对机械通气患者行可视化吸痰试验是可行的。在实时图像指导下,VSSS具有高效、黏膜损伤小的优点,可望为临床吸痰操作提供一个新的平台。
[Abstract]:Objective: sputum aspiration is a common clinical procedure, because of its blind complications. Recently, a visualized sputum suction instrument was developed by our team members. The purpose of this study was to evaluate the feasibility and safety of visualized sputum aspiration in patients with mechanical ventilation and to explore its clinical value. Methods: from February to June 2014, 20 patients who were treated with mechanical ventilation in (RICU), Department of Respiratory Internal Medicine, first affiliated Hospital of Chongqing Medical University, were randomly divided into visual sputum aspiration group (Visual Suction,). VS) and (Closed Suction, CS) in closed suction group. The visualized sputum suction instrument (Visual Sputum Suction System, VSSS) consists of a micro fiber (Outer Diameter, OD= 0.813mm inserted into a two-chamber sputum suction tube. The changes of HR,MAP and Sp02 during sputum aspiration, the incidence of adverse events and the degree of mucosal injury under fiber-optic vision were evaluated. Results: there was no significant change in cardiopulmonary parameters before and after closed sputum aspiration (P0. 14, P0. 33, P0. 08. Respectively), visual sputum suction instrument had an effect on SpO2,HR and MAP (P < 0. 01, P0. 04, P0. 01, respectively),). However, most of them recovered to baseline level at 3 min (P0. 13, Pu 0. 55, Pi 0. 78, respectively), and 5 min after sputum aspiration), and the Sp02 value was higher than that of the traditional closed sucking method (P0. 01). Compared with the traditional CS method, VS can reduce the number of sputum aspiration per day (P0.01). Under real-time guidance, VS can reduce airway mucosal injury and bleeding caused by sputum aspiration. Conclusion: visual sputum aspiration test is feasible for patients with mechanical ventilation. Under the guidance of real-time images, VSSS has the advantages of high efficiency and less mucosal damage, which is expected to provide a new platform for clinical sputum aspiration.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R472

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