改进密闭气道吸痰技术在重症肺炎患者中的应用

发布时间：2019-01-07 09:02

【摘要】：目的对比密闭气道和改进密闭气道吸痰技术在重症肺炎患者中的应用效果。方法选取2013年1月—2014年1月天津医科大学总医院收治的17例机械通气超过24 h的重症肺炎患者,按照入院顺序单双号分为观察组9例和对照组8例。患者均采取按需吸痰的方式,对照组给予常规吸痰法,观察组给予试验改进的密闭气道吸痰技术,带管期间每天记录患者的第一次吸痰的情况。检测患者安全性指标:能否耐受,吸痰前及吸痰后的即刻心率(HR)、平均动脉压(MAP)、血氧饱和度(Sp O2),有无气道黏膜损伤;效果指标:单次吸痰量,24 h吸痰次数及痰液总量,吸痰彻底情况;预后指标:气管插管时间,ICU入住时间。结果共记录121例次吸痰情况,其中对照组57例次,观察组64例次。两组患者吸痰前及吸痰后HR、MAP、Sp O2及吸痰耐受性、黏膜出血发生率比较,差异均无统计学意义(P0.05)。两组24 h吸痰总量和痰鸣音得分比较,差异均无统计学意义(P0.05);观察组单次吸痰量高于对照组,24 h吸痰次数少于对照组(P0.05)。两组气管插管时间和ICU入住时间比较,差异均无统计学意义(P0.05)。结论改进密闭气道吸痰技术安全性稳定,效果好,同时减少了临床护理的工作量,提高护士工作效率,减少了患者因吸痰操作而增加的恐惧感,达到了护患均满意,可在临床推广应用。
[Abstract]:Objective to compare the application effect of closed airway and improved airways suction technique in patients with severe pneumonia. Methods from January 2013 to January 2014, 17 patients with severe pneumonia with mechanical ventilation for more than 24 hours were selected and divided into observation group (n = 9) and control group (n = 8). The control group was given routine sputum aspiration, the observation group was given the improved closed airway suction technique, and the first time of sputum aspiration was recorded every day during the period of the tube. The safety indexes of patients were as follows: tolerance, mean heart rate (HR), arterial pressure (Sp O 2) before and immediately after sputum aspiration, and no airway mucosal damage. Outcome measures: single sputum aspiration, 24 h sputum suction times, total sputum volume, complete sputum aspiration, prognosis: tracheal intubation time, ICU stay time. Results 121 cases of sputum aspiration were recorded, including 57 cases in the control group and 64 times in the observation group. There was no significant difference between the two groups in HR,MAP,Sp O2, sputum tolerance and mucosal bleeding rate before and after sputum aspiration (P0.05). There was no significant difference in the total amount of sputum aspiration and the score of phlegm sound between the two groups (P0.05); the amount of single sputum aspiration in the observation group was higher than that in the control group, and the number of sucking sputum at 24 h in the observation group was lower than that in the control group (P0.05). There was no significant difference in tracheal intubation time and ICU occupancy time between the two groups (P0.05). Conclusion the improved technique is safe and effective. It can reduce the workload of clinical nursing, improve the working efficiency of nurses, reduce the increasing fear of the patients because of sputum aspiration, and achieve the satisfaction of both nurses and patients. It can be popularized and applied in clinic.
【作者单位】：天津医科大学总医院;
【分类号】：R563.8

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