肺叶切除术后患者持续低负压吸引的效果观察  

Observation of Effects of Low Negative Pressure Continuous Suction on Patients Undergoing Pulmonary Lobectomy

作　　者：郑秋霞[1] 沈荷娟[1] 周勇清[1] 尚文军[1] 

机构地区：[1]丽水市人民医院心胸外科,浙江丽水323000

出　　处：《护理学报》2009年第22期34-35,共2页Journal of Nursing（China）

摘　　要：目的探讨持续低负压吸引在肺叶切除术后患者中的应用效果。方法将行肺叶切除术的86例患者,按入院日期的单双号分组,单号为对照组41例,双号为负压吸引组45例。对照组术后胸腔闭式引流管连接三腔的胸腔闭式引流瓶(以下简称胸腔引流瓶)进行引流,未进行负压吸引;负压吸引组术后胸腔闭式引流管除连接胸腔引流瓶外,患者术后回病房时立即在胸腔引流瓶的调压阀上连接中心负压持续吸引,压力设定为-5～-10 cmH2O(1 cmH2O=0.098 kPa)。观察比较两组24 h肺复张率、气体消失的时间、拔管时间、住院时间、肺不张及肺部感染的发生率。结果负压吸引组24 h肺复张率高于对照组(P<0.01);气体消失时间、拔管时间、住院时间均短于对照组(P<0.05);肺部感染及肺不张的发生率低于对照组(P<0.05)。结论肺叶切除术后采用低负压持续吸引能促进患者肺复张,预防肺不张、肺部感染的发生,缩短胸腔引流管的留置时间及住院时间。护理中应严密观察压力的大小,避免压力波动影响吸引的效果和产生并发症。Objective To explore the effects of low negative pressure continuous suction on patients undergoing pulmonary lobectomy. Methods 86 cases undergoing pulmonary lobectomy were, according to the oddness or evenness of the hospitalization serial number, into the control group （n=41） and the suction group （n=45）. Closed thoracic drainage tube connected to the drainage bottle was used for the drainage for the control group, without low negative pressure being used, and the suction group, after returning to the ward, were offered continuous low negative pressure suction by connecting the pressure adjusting valve to the central low negative pressure, with the pressure set at -5-10 cmH20 （1 cmH20=0.098 kPa）. Then a comparison was made of the 24-hour lung recruitment rate, the time of gas disappearing, extubation time, admission time, and the incidence rate of pulmonary atelectasis and pulmonary infection. Results The rate of lung recruitment among the low negative pressure suction group was higher than that among the control group （P〈0.01）; the times of gas disappearing, extubation and admission were shorter than those among the control group （P〈0.05）; the incidence rates of pulmonary atelectasis and pulmonary infection were lower than those among the control group （P〈 0.05）. Conclusion Low negative pressure continuous suction, employed for patients undergoing pulmonary lobectomy, can reduce the incidences of puhnonary atelectasis and pulmonary infection, shorten the times of tube retention and hospital stay. In nursing, pressure should be closely watched so that the drainage effect won＇t be affected and complications won＇t be incurred because of the pressure fluctuation.

关 键 词：肺叶切除术 胸腔引流 负压吸引 肺不张 肺部感染 

分 类 号：R473.6[医药卫生—护理学]