关于机械通气患儿胃内容物误吸影响因素的研究  

Study on influencing factors of aspiration of gastric contents in mechanic ventilated children

作　　者：王祎[1] 左泽兰[1] 代江涛[2] 

机构地区：[1]重庆医科大学附属儿童医院PICU,重庆400014 [2]重庆医科大学附属儿童医院胸心外科,重庆400014

出　　处：《重庆医科大学学报》2010年第7期1122-1124,共3页Journal of Chongqing Medical University

摘　　要：目的:探讨体位、年龄、胃液中胃蛋白酶含量和不同疾病对胃内容物误吸的影响。方法:选择气管吸出物中胃蛋白酶含量作为检测指标,采用自身对照的方法,将20名0～8岁不同疾病的机械通气患儿分别采取30°仰卧斜坡卧位和俯卧位,采取某种体位1、2、3h后收集气管吸出物,测定其中胃蛋白酶的含量,同时测定每位患儿胃液中胃蛋白酶含量。结果:同一时间点,俯卧位时气管吸出物中胃蛋白酶含量小于30°仰卧斜坡卧位(P<0.05);年龄<1y的患儿气管吸出物中胃蛋白酶含量高于年龄≥1岁的患儿(P<0.05);胃液中胃蛋白酶含量和疾病种类对气管吸出物胃蛋白酶含量无明显影响(P>0.05)。结论:俯卧位与30°仰卧斜坡卧位相比可以明显减少误吸;Objective：To assess their influence on position,age,pepsin in gastric juice and different diseases to aspiration of gastric contents.Methods：To choice pepsin levels in tracheal aspirates as an indicator,the own control designing was adopted in the present study.Twenty mechanical ventilated children in different diseases who were 0-8 years old were nursed prone position and 30°supine fowler position.Tracheal aspirates were harvested at 1 hour,2 hours and 3 hours in different body positions and pepsin levels in tracheal aspirates were measured.At the same time pepsin levels in gastric contents were measured.Results：At the same time pepsin levels in tracheal aspirates at prone positioning were obviously less than that at 30°supine fowler position（P0.05）.Pepsin in tracheal aspirates the chidren1yr of age were obviously more than that the children≥1yr of age（P0.05）.Pepsin levels in tracheal aspirates were no pronounced differences in different diseases（P0.05）.Conclusion：Aspiration of gastric contents at prone positioning were smaller than that at 30°supine fowler position.Pepsin levels may generally apply in paediatrics as an indicator.

关 键 词：胃蛋白酶 俯卧位 30°仰卧斜坡卧位 机械通气 误吸 

分 类 号：R473.72[医药卫生—护理学]