摘要
目的探讨机械通气条件下,不同黏稠度模拟痰液的流动状态,以供临床参考。方法选择1只巴马小猪,将配制的相当于Ⅰ度、Ⅱ度、Ⅲ度黏度模拟痰液经气管镜导管注射至段支气管。将猪翻转180°后,观察模拟痰液向气管流动的速度,观察1min,然后向段支气管注入2mL生理盐水进行湿化,10s后将猪翻转180°,观察痰液向气管流动的速度,流至隆突时停止。结果Ⅲ度痰液黏附于支气管壁不流动;Ⅱ度痰液集中于段支气管开口,在表面张力作用下不流动;Ⅰ度痰液流动速度2mm/min。Ⅲ度痰液用生理盐水湿化后,痰液的流动速度为120mm/min,15s流至隆突。结论机械通气条件下,Ⅲ度和Ⅱ度痰液几乎不流动,Ⅰ度痰液流动缓慢,应注意加强气道湿化。气道内注射生理盐水湿化后,翻转180°体位后吸痰应在15s内进行,以避免痰液流向对侧肺导致感染播散。
Objective To explore the flow pattern of sputum with different simulated viscosity in mechanical ventilation,and to guide clinic.Methods One Bama pig was prepared and injected with simulated sputum which was equivalent toⅠ,Ⅱ,or Ⅲ degree viscosity,via bronchoscope catheter into the segmental bronchi.The flow rate of the simulated sputum was observed for 1 minute after the pig was turned 180 degrees,and it was injected with 2 milliliter normal saline into segmental bronchus for humidification.Then the pig was turned 180 degree back 10 seconds later,and the flow rate of the simulated sputum to trachea was observed until it flowed to the carina.Results The Ⅲ degree viscosity sputum adhered to bronchial wall and didn′t flow,theⅡdegree viscosity sputum aggregated to the opening of the segmental bronchus and didn′t flow yet because of surface tension,and the flow rate ofⅠdegree viscosity sputum was 2 millimeters per minute.While the flow rate of Ⅲ degree viscosity sputum was 120 millimeters per minute after humidification by normal saline,and spent 15 seconds flowed to the carina.ConclusionIn mechanical ventilation,the sputum of Ⅱand Ⅲ degree viscosity almost don′t flow,and theⅠdegree viscosity sputum flows slowly,it is necessary to strengthen airway humidification.After humidification by injection of normal saline,sputum suction should be carried out within 15 seconds after turned 180 degree,to avoid the sputum flowed into the contralateral lung and infection spread.
作者
张俊丽
卜金龙
孙文武
柴若楠
Zhang Junli,Pu Jinlong,Sun Wenwu,Chai Ruonan(Department of Respiratory and Critical Care Medicine,General Hospital of Shenyang Military Command,Shenyang 110016,Chin)
出处
《护理学杂志》
CSCD
北大核心
2018年第6期54-56,共3页
Journal of Nursing Science
基金
辽宁省自然科学基金项目(2015020456)
沈阳军区总医院青年基金项目(08Y-Q15)
关键词
机械通气
痰液
黏稠度
体位
流变学
动物实验
mechanical ventilation
sputum
viscosity
position
rheology
animal experiment
