Shallow 吸痰法在机械通气新生儿中的应用

目的：观察Shallow吸痰法对机械通气新生儿的影响。方法将2012年6月-2013年3月86例在新生儿科重症监护室行机械通气患儿作为研究对象，采用随机数字表法将86例患儿随机分成对照组和观察组，对照组40例患儿予常规吸痰方法，观察组46例患儿行Shallow法吸痰，观察两组患儿的吸痰间隔时间、气管黏膜损伤、人工气道阻塞发生次数、心率和脉搏氧饱和度（ SpO2）的变化。结果观察组患儿共吸痰296次，对照组252次。观察组吸痰时发生SpO2低于85％5次，显著低于对照组的33次，差异有统计学意义（χ2＝27．44，P＜0．05）；观察组吸痰时间为（8．10±1．36）s，显著低于对照组的（12．50±1．46）s，差异有统计学意义（t＝2．650，P＜0．05）；观察组发生气道黏膜损伤为0次，显著低于对照组的12次，差异有统计学意义（χ2＝14．410，P＜0．05）；两组心率异常发生次数、吸痰间隔时间和人工气道阻塞发生次数比较，差异均无统计学意义（χ2/t 分别为1．217，0．761，0．003；P ＞0．05）。结论 Shallow吸痰法具有吸痰时间短，减少低氧血症的发生，减轻对新生儿气道的刺激和黏膜的损伤等优点，值得推广。

Application of Shallow suction in mechanical ventilation among neonates

Objective To observe the effect of shallow suction of endotracheal in ventilated neonates . Methods Eighty-six infants, from June 2012 to March 2013, were divided into observation group and control group using the random number table .The 40 infants in control group were used for traditional suction;the 46 infants in observation group were used for Shallow suction .The difference of interval time of suctions , trachea mucosal injury , frequency of artificial airway block , changes of heart rate and SpO 2 were compared between the two groups .Results The total times of sputum suction were 296 in observation group and 252 in control group .＆amp;nbsp;In observation group , the frequency of SpO 2 below 85% among infants was 5 times, which was less than 33 times in control group.The difference was significant （χ2 =27.44, P ＆lt;0.05）.The time of suction was （8.10 ＆#177;1.36）s in observation group and （12.50 ＆#177;1.46）s in control group, and the difference was significant （t=2.650, P＆lt;0.05）.The frequency of trachea mucosal injury was 12 times in control group, compared to 0 in observation group, which was significantly different （χ2 =14.410,P ＆lt;0.05）.However, there was no obvious difference in heart rate , interval time between suctions and artificial airway block （χ2/t =1.217, 0.761,0.003,P＆gt;0.05）.Conclusions The shallow suction of endotracheal is benefit in shortening the suction time, decreasing the frequency of hypoxemia , reducing the influence of airway and the mucosal injury , compared with traditional suction .Thus, we recommend that the shallow suction is worthy to being widely used in clinical interventions .