肺复张策略在早产儿气管内吸痰时的应用

目的观察肺复张策略在呼吸窘迫综合征早产儿气管内吸痰时的应用效果。方法2011年9月至2012年4月将30例需要机械通气的呼吸窘迫综合征早产儿采用随机数字表法分为观察组和对照组，每组各15例。对照组采用开放式吸痰法（OSS），观察组在OSS的基础上加用肺复张策略（LRM）。比较两组早产儿吸痰前后的脉搏氧饱和度（SpO2）、心率（HR）、吸痰时SpO2超出范围的次数、吸痰后的SpO2及HR（心率）恢复时间等变化。结果观察组SpO2变化值及SpO2恢复时间分别为（9±3）％，（9±3）s；对照组为（14±4）％，（14±5）s，两组比较，差异均有统计学意义（Z值分别为-3．205，-2．976；P〈0．05）。两组患者的HR变化值及HR恢复时间比较，差异无统计学意义（Z值分别为-1．798，-1．344；P〉0．05）。观察组吸痰时Sp02超出范围的次数为（1．60±0．74）次，对照组为（3．13±1．06）次，两组比较，差异有统计学意义（Z=-3．654，P〈0．05）。两组患者呼吸机及氧气应用时间比较，差异无统计学意义（Z值分别为-1．350，-1．764；P〉0．05）。结论吸痰前后使用肺复张策略可以维持SpO2的稳定，减少缺氧的发生。

Application of lung recruitment maneuver in preterm infants during endotracheal suctioning

Objective To observe the effect of lung recruitment maneuver（LRM） on preterm infants with respiratory distress syndrome during endotracheal suctioning. Methods Totals of 30 preterm infants with respiratory distress syndrome who supported by mechanical ventilation were randomly divided into observation group （n = 15 ） and control group （n = 15 ）. Patients in control group received sputum suction with open system suction（OSS）, and patients in observation group were given OSS plus LRM. The pulse oxygen saturation （SpO2 ） , heart rate （HR） , recovery time of SpO2 and HR were observed and compared between two groups. Results The HR changes in observation group was （ 11 ± 2 ） times/min and that in the control group was （ 14 ± 5 ） times/min, no significant difference was detected. The SpO2 changes and SpO2 recovery time in the observation group respectively were （9 ± 3 ） % and （9 ± 3 ） s, and that in the control group were （ 14 ± 4 ） % and （ 14 ~ 5 ） s, and the difference was statistically significant （ Z = - 3. 205, - 2. 976 ; P 〈 0.05 ）. No significant difference in HR recovery time and HR changing, lasting time of mechanical ventilation were detected between the two groups （Z = - 1. 350, - 1. 764 ; P 〉 0.05）. Conclusions LRM can maintain SpO2 stability and reduce the incidence of hypoxia during OSS.