摘要
目的为有效清除昏迷病人气道分泌物,减少反复插管引起的气道损伤。方法将67例Glasgow7级以下的昏迷病人进行常规法和呛咳刺激法吸痰,常规组取平卧位或平卧头侧位,从口或鼻插入吸痰管,吸除气道分泌物。呛咳刺激法吸痰作用于在充分左,右侧卧位拍背以后,取平卧头后仰位,先用生理盐水20～30ml,从臼齿处注入口腔,使其流向舌根部,再从鼻插入吸痰管,感到有阻力时轻旋痰管引起病人呛咳,趁其呛咳时将吸痰管推入气道深处到25～28cm,负压吸引并缓慢向外拔出,吸除气道分泌物时间不可超过15秒。将两种方法吸出痰量,痰液性状和一次插管成功率进行比较。结果两种吸痰方法在一次插管成功率,吸出痰量和痰液性状上均存在显著性差异(P<0.01)。呛咳刺激吸痰法吸出痰量多(大于5ml占85%),而粘稠且一次插管成功率高达97%。结论呛咳刺激吸痰法能提高一次插管成功率,有利于吸出昏迷病人气道深部痰液,防止气道阻塞,对控制感染和改善通气有重要意义。
Objective To clear airway secretion of coma patient and reduce airway damage with repeated intubation tube. Methods 67cases coma patient with below Glasgow 7 degree give routine method and choke cough stimulate aspiration. The routine group with supine position or horizontal temporal position, insert aspiration tube from oral cavity or nosal cavity and draw secretory. The method of choke with horizontal head hypsokinesis after left and right lateral position following the patting back , 20 - 30ml normal saline solution from molar to root of tongue, the aspiration tube insert nosal cavity, having resistance slight revolve tube inducing patient chock cough and insert tube into trachea 25 - 28cm. Vacuum suction and extraction slowing ,the time is less 15 second. Two method compared with amount of expectoration, property sputum and rate of one intubation tube success. Results Two method have significant difference （P ＜ 0.01）. Choke cough stimulate aspiration can suction more sputum（ ＞ 5ml, 85%）, and viscous. Rate of one intubation tube success was 97%. Conclusions Choke cough stimulate aspiration can improve rate of one intubation tube success. It can obviously beneficial draw deep juice of coma patient, preventing airway obstruction. It is important significance to control infection and improve ventilation.
出处
《现代护理》
2005年第14期1107-1108,共2页
Modern Nursing
