摘要
目的探讨接受有创机械通气的呼吸衰竭患者实施不同侧向旋转吸痰治疗时间的临床疗效。方法选取自2017年7月至2019年12月收治的因各种肺部疾病合并感染引起呼吸衰竭行有创机械通气的150例ICU患者为研究对象。按照随机数字表法分为A组、B组、C组,A、B、C组患者分别在侧向旋转后10、15、20 s进行吸痰。比较3组吸痰治疗后的气道内吸痰治疗成功率、呼吸机相关性肺炎发生率、住院时间、费用、血氧饱和度及吸痰前后的心率、呼吸频率、血压等。结果3组患者的气道内吸痰治疗成功率、呼吸机相关肺炎发生率及吸痰前、后的心率、呼吸频率、血压比较,差异无统计学意义(P>0.05)。B组患者入住ICU时间及费用、住院时间及费用均低于A组、C组,差异有统计学意义(P<0.05)。C组住ICU费用、住院费用显著高于A组,差异有统计学意义(P<0.05)。3组患者吸痰前2 min血氧饱和度比较,差异无统计学意义(P>0.05)。吸痰后5 min,B组与C组患者血氧饱和度高于吸痰前,差异有统计学意义(P<0.05)。结论对于气管插管机械通气患者,侧向旋转吸痰治疗策略是安全、有效的方法。翻身、叩背后15 s吸痰治疗较佳。
Objective To investigate the clinical effect of different time of lateral rotation sputum aspiration in patients with respiratory failure receiving invasive mechanical ventilation.Methods A total of 150 ICU patients who received invasive mechanical ventilation due to respiratory failure caused by various pulmonary diseases and infections from July 2017 to December 2019 were selected as subjects.According to the random number table method,they were divided into A group,B group and C group.Patients in A group,B group and C group received sputum aspiration at 10,15 and 20 s after lateral rotation,respectively.The success rate of endotracheal sputum aspiration after sputum aspiration,incidence of ventilator associated pneumonia,length of hospital stay,cost,oxygen saturation of finger pulse,heart rate,respiratory rate and blood pressure before and after sputum aspiration were compared among the three groups.Results There were no significant differences in the success rate of endotracheal sputum aspiration treatment,the incidence of ventilator-associated pneumonia,the heart rate,respiratory rate and blood pressure before and after sputum aspiration among 3 groups(P>0.05).The cost and duration of ICU stay and hospitalization in B group were significantly lower than those in A group and C group,the differences were statistically significant(P<0.05).There was no significant difference in pulse oxygen saturation 2 min before sputum aspiration among 3 groups(P>0.05).Five minutes after sputum aspiration,the oxygen saturation of finger pulse in B group and C group was higher than that before sputum aspiration,the difference was statistically significant(P<0.05).Conclusion Lateral rotation sputum aspiration is a safe and effective method for patients with endotracheal intubation mechanical ventilation.It is better to turn over and knock behind 15 s for sputum aspiration.
作者
张俊丽
张颖
王敏
赵莹
李丹阳
黄荷花
柴若楠
ZHANG Jun-li;ZHANG Ying;WANG Min;ZHAO Ying;LI Dan-yang;HUANG He-hua;CHAI Ruo-nan(Department of Respiration and Critical Medicine,General Hospital of North Theater Command,Shenyang 110016,China)
出处
《创伤与急危重病医学》
2022年第6期408-411,共4页
Trauma and Critical Care Medicine
关键词
侧向旋转吸痰
气管插管
机械通气
流体动力学
Lateral rotation of sputum aspiration
Endotracheal intubation
Mechanical ventilation
Fluid dynamics
