密闭浅层呼吸机膨肺吸痰法在心脏术后患者中的应用及效果评价

  目的  探讨密闭浅层呼吸机膨肺吸痰法在心脏术后患者中的应用及效果，旨在为心脏术后患者吸痰方式的选择提供参考。  方法  以2020年2—8月中国科学技术大学附属第一医院收治的心脏术后患者221例为研究对象，采用随机数字表法分为对照组和观察组，对照组110例给予传统膨肺吸痰，观察组111例给予密闭浅层呼吸机膨肺吸痰。比较2组患者的机械辅助通气时间、吸痰后的心率恢复时间、末梢血氧饱和度恢复时间及痰鸣音改善评分。  结果  对照组患者的机械通气时间为(11.93±5.83)h，观察组为(9.92±3.61)h，2组比较差异有统计学意义(t=3.083，P＜0.05);观察组心脏术后患者吸痰结束后的心率恢复时间、血氧饱和度恢复时间均明显低于对照组(t=2.707、4.591，均P＜0.05);对照组患者痰鸣音改善评分为(2.69±0.55)分，观察组为(2.86±0.35)分，2组比较差异有统计学意义(t=2.641，P＜0.05)。  结论  与常规人工膨肺吸痰比较，密闭浅层呼吸机膨肺吸痰法可缩短成人心脏术后患者的机械通气时间，稳定患者的生命体征并改善术后患者的痰鸣音情况，推荐密闭浅层呼吸机膨肺吸痰作为此类患者气管内吸痰的优选方法。 

Application and effect evaluation of airtight shallow ventilator lung dilated suction in postoperative cardiac patients

  Objective  During cardiac surgery, the lung is inevitably affected by cardiac surgery because the surgery requires incision of the sternum and disrupts the continuity of the sternum. Cardiac surgery is time-consuming, resulting in longer alveolar collapse time during surgery, which requires higher requirements for postoperative airway care. This study investigates the application and effect of airtight shallow ventilator lung dilated suction in postoperative cardiac patients, aiming to provide reference for the selection of suction method for postoperative cardiac patients.  Methods  A total of 221 postoperative cardiac patients admitted to the First Hospital of the University of Science and Technology of China from February 2020 to August 2020 were taken as the study subjects. They were divided into control group (110 cases) and observation group (111 cases) using random number table method. The patients in the control group were given conventional lung dilated suction and patients in the observation group were given airtight shallow ventilator lung dilated suction. The mechanical assisted ventilation time, heart rate recovery time after suctioning, terminal oxygen saturation recovery time and sputum sound improvement scores of the patients in the two groups were compared.  Results  The time of mechanical ventilation was (11.93±5.83) h in the control group and (9.92±3.61) h in the observation group, and the difference was statistically significant (t=3.083, P < 0.05). The heart rate recovery time and oxygen saturation recovery time after the end of sputum aspiration in patients in the observation group after cardiac surgery were significantly lower than those in the control group (t=2.707, 4.591, all P < 0.05). The sputum sound improvement score was (2.69±0.55) points in the control group and (2.86±0.35) points in the observation group, and the difference was statistically significant (t=2.641, P < 0.05).  Conclusion  Compared with conventional manual lung dilated suction, airtight shallow ventilator lung dilated suction can shorten the duration of mechanical ventilation in adult postoperative cardiac patients, stabilize the patients'vital signs and improve the sputum sound in postoperative patients. Airtight shallow ventilator lung dilated suctioning is recommended as the preferred method of endotracheal suctioning in these patients.