摘要
目的探讨震颤结合体位引流用于密闭式吸痰的排痰效果。方法选择40例机械通气患者随机分为观察组和对照组,每组各20例。对照组采用单纯密闭式吸痰法,观察组采用密闭式吸痰辅以震颤结合体位引流法。比较两种操作方法每次排痰量、吸痰彻底情况、吸痰前后10minSpO2的变化;比较两组患者日均吸痰次数、呼吸机相关性肺炎(VAP)的发生率和发病时间及机械通气时间。结果密闭式吸痰辅以震颤结合体位引流法在每次排痰量、吸痰彻底情况方面明显优于单纯密闭式吸痰法(P<0.05);在吸痰前后10minSpO2的变化方面,两操作法吸痰前后SpO2比较均无显著性差异(P>0.05)。观察组日均吸痰次数、VAP发病时间和机械通气时间方面明显优于对照组(P<0.05),观察组VAP发生率较对照组低,但统计学方面无显著性差异(P>0.05)。结论震颤结合体位引流用于密闭式吸痰可以提高密闭式吸痰的有效性,可以彻底吸净痰液,减少吸痰次数,减少因频繁吸痰而引起患者不必要的刺激,延迟VAP发生时间,缩短机械通气时间,从而减轻患者的痛苦和经济负担,促进患者康复,值得推广。
Objective To explore the effects of sputum elimination of tremor combined with postural drainage used in the closed endotracheal suction. Methods 40 patients with mechanical ventilation were randomly divided into observation group （n=20） and control group （n=20）. The patients used simple closed endotracheal suction in the control group; the patients used closed endotracheal suction in the observation group and assisted by tremor combined with postural drainage. The sputum volume, complete sputum, changes of SpO2 10 rain before and after suctioning were compared, and the times of daily suction, incidence and onset time of ventilator-associated pneumonia （VAP） and time of mechanical ventilation were also compared. Results The sputum volume and complete sputum in the observation group were significantly better than those in the control group （P〈0.05）; there was no significantly difference in changes of SpO2 10 min before and after suctioning between two groups （P〉0.05）. The times of daily suction, onset time of VAP and time of mechanical ventilation were significantly better than those in the control group （P〈0.05）. The incidence of VAP in the observation group was lower than that in the control group, but there was no statistical difference （P〉0.05）. Conclusion The tremor combined with postural drainage can improve the efficacy of closed endotracheal suction, completely clean sputum and reduce the times of suction; prolong the onset time of VAP and shorten the time of mechanical ventilation, which can lighten the patients＇ suffering and economic burden; and promote recovery of the patients; this method is worthy to be popularized.
出处
《中国医药指南》
2009年第13期19-21,共3页
Guide of China Medicine
关键词
震颤
体位引流
密闭式吸痰
机械通气
Tremor
Postural drainage
Closed endotracheal suction
Mechanical ventilation
