两种吸痰负压对急性呼吸窘迫综合征病人血流动力学及血氧饱和度的影响  

Influence of two different ways of negative pressure sputum aspiration on hemodynamics and blood oxygen saturation of patients with acute respiratory distress syndrome

作　　者：李晓芳[1] 高敏[1] 程青虹[2] 徐瑾媛[2] 马文娟[2] 

机构地区：[1]石河子大学医学院 [2]石河子大学医学院第一附属医院

出　　处：《护理研究（上旬版）》2010年第4期873-875,共3页Chinese Nursing Researsh

摘　　要：[目的]比较两种吸痰负压对急性呼吸窘迫综合征(ARDS)病人血流动力学及血氧饱和度的影响,选择合适的吸痰负压。[方法]在重症监护病房选取ARDS并行机械通气治疗的病人20例,每例病人均使用小负压(≤20.0kPa)和大负压(>20.0kPa,≤26.7kPa)两种吸痰负压进行吸痰,吸痰顺序随机选择,观察记录病人在不同吸痰负压下,吸痰前后各个时间段的脉搏血氧饱和度(SpO2)、心率、平均动脉压的变化;记录两种吸痰负压吸痰后SpO2下降的最大值、下降至最低值的时间、恢复至基线的时间。[结果]小负压吸痰SpO2在吸痰后0s、15s下降显著(P<0.05或P<0.01);大负压吸痰后SpO2在吸痰后0s、15s亦下降显著(P<0.01);两种吸痰负压对心率、平均动脉压的影响均无统计学意义(P>0.05);两种吸痰负压比较各指标差异均无统计学意义(P>0.05);两种吸痰负压吸痰后SpO2下降的最大值、下降至最低值的时间、恢复基线的时间比较均无统计学意义(P>0.05),但大负压吸痰后SpO2恢复至基线的时间较长。[结论]两种吸痰负压对ARDS病人均引起SpO2不同程度的降低,对血流动力学影响均较小,同等条件下采用小负压吸痰较好。Objective： To compare two different ways of negative pressure sputum aspiration on hemodynamics and blood oxygen saturation of patients with acute respiratory distress syndrome（ARDS）,and to find out an appro priate negative pressure for sputum aspiration. Methods：A total of 20 ARDS patients in intensive care unit accepting mechanical ventilation treatment were selected. Each was using low negative pressure（≤20 kPa）and high neg ative pressure（〉20.0 kPa,≤26.7 kPa） to aspirate sputum. And sputum aspiration method was chosen randomly in sequence. Pulse oxygen saturation （SpO2） ,heart rate,and mean arterial pressure changes of all patients at different negative pressure and in various time periods before and after sputum aspiration were recorded. The maximum decreasing of SpO2, the time of down to the lowest value, and the time returned to the baseline of SpO2 of all cases had also been recorded. Results. SpO2 of patients was significantly decreased right after accept;ng low negative pressure to aspirate sputum and on 15 s of aspiration （P〈0.05 or P〈0.01）. SpO2 of patients fell significantly at 0s and 15 s after accepting high negative pressure for sputum aspiration （P〈0.01）. There were no statistically significant differences in terms of heart rate,mean arterial pressure of patients after accepting two ways of negative pressure sputum aspiration （P〉0.05）. In terms of the maximum decreasing of SpO2, the time of down to the lowest value,and the time returned to the baseline of SpO2, there were no statistical significance differences in patients after accepting the two ways of negative pressure aspiration （P〉0.05）. However, the mean time of SpO2 returned to baseline in patients accepting high negative pressure aspiration was trended to be prolonged. Conclusions：Two different ways of sputum aspiration for ARDS patients may cause their SpO2 decline to different degrees. However,it has little impact on their hemodynamics. Under the same condition, low negative pres

关 键 词：急性呼吸窘迫综合征 机械通气 气道内吸痰 吸痰负压 血氧饱和度 心率 平均动脉压 

分 类 号：R473.5[医药卫生—护理学]