摘要
目的:研究不同吸痰方式对急性呼吸窘迫综合征(ARDS)机械通气患者呼吸力学的影响。方法:选择28例ARDS并行机械通气治疗患者,随机分为两组,A组(n=14):先进行密闭式吸痰(CS),后施行开放式吸痰(OS);B组(n=14):先进行OS,后施行CS。观察记录两组患者行不同方式吸痰后1分钟呼吸系统力学参数的变化。结果:两种吸痰方式均不影响呼吸系统顺应性(Cst)(P>0.05),但开放式吸痰可致吸气阻力(Raw)升高(P<0.05)。结论:不同吸痰方式对ARDS机械通气患者呼吸力学影响主要集中在吸气阻力,开放式吸痰使吸气阻力增高,两者对呼吸系统顺应性无影响。建议对应用机械通气的ARDS患者使用气管内吸痰首选密闭式吸痰方法。
Objeetive：This study aimed to the effect of different modes of sputum aspi- ration on respiratory mechanics in aeute re- spiratory distress syndrome （ARDS） patients with wmtilation.Methods：28 ARDS patients received mechanical ventilator,were ran- domly divided into two groups,In A group （n=14）：thc patient received closed aspira- tion（CS） firstly,and then reeeived opend as- pi ration（OS）.In B group（n= 14）：the patient re- ceived OS,and then received CS.The respi- ratory mechanics changes were recorded l min after aspiration finished.Results：The two different modes of aspiration had no ef- fect on respiratory complianee（Cst）（P 〉 0.05）, but the opened modes resuhed in an in- creased inspiratory resistance （Raw）（P〈 0.05）.Conclusion：The different aspiration modes mainly concentrated in the inspirato- ry resislance.The opened modes increased inspiratory resistance.There was no effect on the respiratory compliance.The closed aspi- ration system could be the first choice for airway management in ARDS patients with ventilation.
关键词
急性呼吸窘迫综合征
气管内吸痰
呼吸力学
Acute respiratory distress syn- drome
Transtracheal aspiration
respiratory mechanics
