膨肺吸痰法在呼吸衰竭患者机械通气中的应用

目的探讨膨肺吸痰法（MHI）在呼吸衰竭患者机械通气中的应用价值。方法选择我院RICU和综合ICU因呼吸衰竭行人工机械通气的患者150例,随机分为MHI组和对照组,MHI组行膨肺吸痰,对照组行常规吸痰。比较两组肺不张的发生率,吸痰前后动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2）和机械通气时间。结果①MHI组肺不张的发生率明显低于对照组（P〈0.05）;②与吸痰前比较,吸痰后MHI组PaO2和SaO2无明显降低（P〉0.05）,而对照组PaO2和SaO2明显降低（P〈0.05）;吸谈后MHI组与对照组比较,MHI组PaO2和SaO2明显增高（P〈0.05）;③MHI组机械通气时间明显缩短（P〈0.01）。结论 MHI能有效避免吸痰后动脉血PaO2和SaO2下降,可缩短机械通气时间,是一种安全、有效的方法。

Applocation of manual hyperinflation on ventilated care patients with respiratory failure

Objective To investigate the the effects of manual hyperinflation on ventilated care patients with respiratory failure.Methods 150 patients from the intensive care units of Bazhong central hospital were randomly assigned to MHI group and control group.Manual hyperinflation treatment involved patient positioning(side-lying),suctioning and manual lung hyperinflation.Control treatment involved patient positioning and suctioning alone.Results There was a significant lower incidence of pulmonary atelectasis in MHI group than in control group(P < 0.05).Patients in the control group showed a decrease of PaO2 and SaO2 after suction(P < 0.05).And there were no significant difference in PaO2 and SaO2 between pre-suctioning and post-suctioning in the group MHI.Patients′ medium hospital stay were 7 and 9 days in MHI and control groups respectively(P < 0.01).Conclusion Manual hyperinflation is either a effective or a secure treatment to reduce the duration of ventilation and avoid the reduction of PaO2 and SaO2 in suction.