密闭式浅层吸痰在机械通气中的应用效果研究

[目的]探讨实施不同的吸痰方式和吸痰深度对机械通气病人的效果，为临床选择安全、有效的吸痰方式提供依据。[方法]将40例行机械通气的病人随机分成两组，观察组采用密闭式浅层吸痰（吸痰管超过气管导管前端1 cm），对照组采用临床常规开放式吸痰（即吸痰管插入气管遇到阻力后上提0.5 cm ~1.0 cm 后吸引），比较两组病人吸痰前后血氧饱和度（SpO 2）、心率（HR）、呼吸频率（R）、潮气量（VT）、平均气道压（Pmean）的变化以及对气道黏膜的损伤等并发症的影响。[结果]观察组病人采用密闭式浅层吸痰后引起呼吸循环变化幅度及气道黏膜损伤程度明显优于对照组，差异有统计学意义（P 〈0.05）。[结论]病人机械通气期间行密闭式浅层吸痰能降低机体的应激反应，减少对气道的刺激及吸痰并发症，是一种安全有效的吸痰方式。

Study on effect of closed shallow suction during mechanical ventilation

Objective：To probe into the effect of implementation of different suction methods and suction depth for patients undergoing mechanical ven-tilation,so as to provide evidences for choose a safe and effective suction method for patients clinically.Methods：A total of 40 patients undergoing mechanical ventilation were randomly divided into two groups,closed and shallow suction （suction tube was inserted over 1 cm of the front end of the endotracheal tube）was adopted for the observation group,the patients in control group applied clinical routine open suction（suction tube was in-serted into endotracheal tube till met resistance,then drawn back 0.5 cm~1.0 cm）,then to compare the changes in oxygen saturation （SpO 2 ）,heart rate （HR）,respiratory rate （RR）,tidal volume （VT）,mean airway pres-sure （Pmean）and airway mucosal damage and influence on complications of airway mucosal injury between two groups before and after suction.Re-sults：After closed suction shallow suction in patients in observation group, breathing and circulation changes magnitude and the degree of airway mu-cosa were significantly better than that in control group,and the difference was statistically significant （P 〈0.05）.Conclusion：Closed shallow suctio-ning during mechanical ventilation for patients can reduce the body’s stress response,reduce airway irritation and suctioning complications,and it is a safe and effective suctioning way.