不同强度负压吸引声门下间隙分泌物的效果比较

目的探讨并比较不同强度负压吸引声门下间隙分泌物的效果。方法 2006年6月至2008年9月,行气管切开或气管插管且使用了可冲洗式气管导管的呼吸科住院患者18名,采用自身对照,分别采用-15 kPa以下（A组）、-15~-20 kPa（B组）、-20~-25 kPa（C组）吸引侧管,每24 h应用1组压力,3 d为1个周期,依次循环,连续10个周期,即每组负压应用10 d,共计30 d。观察并比较三组不同强度负压下行负压吸引引起患者咳嗽反射的频次、每日吸引总量的均值、吸引前与吸引时心率及血氧饱和度的均值。结果负压为-15~-20 kPa时进行声门下间隙分泌物的吸引,对患者造成的不良刺激小,吸引出的分泌物量较多,吸引效果优于其他两组,两两比较差异有统计学意义（P〈0.05）。结论负压为-15~-20 kPa时进行声门下间隙分泌物的吸引,压力适宜,对患者造成的不良刺激小,吸引出分泌物的量较多,吸引效果好,有利于降低呼吸机相关性肺炎的发生率,提高人工呼吸道的护理管理水平,减轻患者的痛苦及医疗资源的浪费,值得在临床推广使用。

Therapeutic Observation on Inferior Glottis Secretion Suction under Different Negative Pressure

Objective To investigate the effects of the inferior glottis secretion suction under different negative aspirating pressure.Methods Using self control method,eighteen respiratory inpatients undergoing tracheotomy or endotracheal intubation with flushable endotracheal tube from June 2006 to September 2008 were divided into group A（-15 kPa）,group B（-15～-20 kPa） and group C（-20～-25 kPa） using side tube suction.Each group of pressure was applied every 24 h.Each circle consisted of 3 d and totally 10 circles were required（each negative pressure group/10 d for 30 d）.The frequency of cough reflex caused by negative pressure suction,the mean value of total daily suction and the mean values of heart rate and blood oxygen saturation before and after the suction in the three groups were observed and compared.Results The stimulation to the patients and the quantity of the secretion when aspiring the inferior glottis secretion under the vacuum of-15～-20 kPa were significantly superior to those the other two pressure groups（P0.05）.Conclusion The inferior glottis secretion under the vacuum of-15～-20 kPa showed the favorable effects with least stimulation and most amount of secretion,which is conducive to reducing ventilator-associated pneumonia rate,improving artificial airway care management and reducing the patient＇s pain and waste of medical resources in clinical practice.