ICU机械通气患者气管内吸痰时插管深度的改进

目的探讨不同插管深度对ICU机械通气患者气管内吸痰效果的影响。方法便利选取2010年10月至2012年3月ICU机械通气患者64例,采用随机数字表法将其分为研究组(深吸痰)和对照组(浅吸痰),比较两组患者吸痰前后的血压、心率、呼吸、血氧饱和度等生命体征变化,以及吸痰效果和吸痰时不良事件的发生率。结果吸痰前后,研究组患者潮气量、呼吸道峰压及血氧饱和度的改善明显优于对照组,差异有统计学意义(P0.01);研究组患者的日吸痰次数、痰鸣音改善情况以及吸痰间隔时间等均优于对照组,差异有统计学意义(P0.05或P0.01);两组患者不良事件的发生率差异无统计学意义(P0.05)。结论 ICU机械通气患者进行人工气道内吸痰时,增加插管深度有助于清除呼吸道内分泌物、延长吸痰间隔时间、改善机体的缺氧状况,同时还不增加不良事件的发生率。

Improvement of Depth of Cannula in Sputum Suction in Patients Receiving Mechanical Ventilation in ICU

Objective To determine efficacy of different depth sputum suction in patients receiving me- chanical ventilation in ICU.Metbods Totally 64 ICU patients with mechanical ventilation were randomly divided into observation group（deep sputum suction） and control group （shallow sputum suction） ,and the changes in blood pressure,heart rate and respiration rate of sputum suction and the oxyhemoglobin satura tion of the two groups of patients were recorded,and the suction effects and the incidence of adverse event were also evaluated.Results The improvement of VT.PAP and SpO2 in observation group were signifi- cantly better than control group （P~0.01）, and daily suction times, improvement of wheezy phlegm and suctioning interval in observation group were also better than control group（P〈0.05 or P〈0.01） Adverse events in the patients of the two groups exhibited no significant difference（P〉0.05）.Conelusion Deeply remove phlegm contributes to respiratory secretions in patients with mechanical ventilation in ICU. Artifi- cial airway suctioning can reduce airway resistance,prolong the suction time interval,improve the anoxic condition of body and not increase the incidence of adverse events.