间歇性膨肺预防开胸术后肺不张的效果

目的探讨间歇性膨肺预防开胸术后肺不张的效果。方法采用便利抽样法选取60例开胸手术后机械通气患者按随机数字表法分为对照组和实验组各30例,实验组在机械通气期间每隔2 h使用呼吸囊进行膨肺治疗,直至停用呼吸机;对照组接受机械通气常规护理。观察两组患者动脉血氧饱和度（SaO₂）、动脉血氧分压（PaO₂）、动脉血二氧化碳分压（PaCO₂）等呼吸参数的变化,以及肺不张的发生率和上机时间。结果实验组患者在停用呼吸机前的PaO₂、PaCO₂及SaO₂高于对照组,平均上机时间及带管时间均短于对照组,肺不张的发生率（0）低于对照组（20%）,差异均有统计学意义（P<0.05或P<0.01）。结论间歇性膨肺能改善开胸手术患者的通气,增加气血交换,预防肺不张,缩短患者的机械通气时间及带管时间。

Effects of Intermittent Lung Inflation in Preventing Atelectasis after Thoracotomy

Objective To study the effect of intermittent lung inflation in preventing atelectasis after thoracotomy. Methods Sixty patients undergoing mechanical ventilation after thoracotomy were randomly divided into control group （N = 30） and experimental group （N = 30）. The patients in the experimental group were treated with an intermittent lung inflation suction method,which were processed every 2 hours until stopping mechanical ventilation. The patients in the control group were received a daily routine method. The changes of SaO2, PaO2, and PaCO2, were observed. The incidence of atelectasis and the period of mechanical ventilation were monitored. Results Compared with the control group, the values of SaO2, PaO2 and PaCO2 were significantly elevated ; the period of mechanical ventilation the duration of retaining canal were significantly less; the incidence of atelectasis（0 vs 20%） was significantly lower in the experimental group（P〈0.05 or P〈0.01）. Conclusion Intermittent lung inflation can significantly increase lung volume and improve oxygenated function. It has a positive effect in preventing and treating atelectasis, besides, reducing the period of mechanical ventilation and duration of retaining canal.