不同吸痰方法对PEEP患者血流动力学影响的研究  

The comparative study of the hemodynamic effects of different methods of suction on patients with PEEP

作　　者：刘爱丽[1] 江丽华[1] 田金飞[1] 张用娥[2] 李骏[1] 李冬梅[1] 毛翔[1] 汤彦[1] 

机构地区：[1]湖北医药学院附属东风医院ICU,湖北十堰442008 [2]湖北医药学院护理学院第二临床学院,湖北十堰442000

出　　处：《护士进修杂志》2011年第6期490-492,共3页Journal of Nurses Training

摘　　要：目的研究开放式吸痰与密闭式吸痰对人工机械通气使用PEEP患者心率(HR)、无创血压(NBP)、中心静脉压(CVP)、心输出量(CO)、心脏指数(CI)、每搏射血量(SV)、左心室作功(LCW)、左心室每搏作功(LVSW)、预射血间期(PEP)等的影响。方法收集2010年1～10月应用机械通气使用PEEP患者,随机分为两组,吸痰护理方法采用普通脱开呼吸机开放式吸痰(OS)与三通接头实行密闭式吸痰(CS)两种方法,观察两组患者吸痰前、吸痰后即刻(PSi)、吸痰后1min(PS1)和5min(PS5)的心率(HR)、无创血压(NBP)、中心静脉压(CVP)、心输出量(CO)、心脏指数(CI)、每搏射血量(SV)、左心室作功(LCW)、左心室每搏作功(LVSW)、预射血间期(PEP)、左心室射血时间(LVET)等情况,观察上述监测值与基线的关系。结果 CS较OS吸痰后1min、5min对血流动力学影响差异有显著意义(P<0.05)。结论 OS、CS均可影响血流动力学的稳定。在护理工作中,对PEEP机械通气者应重视吸痰引起的继发损害,加强吸痰前后血流动力学等监测。CS吸痰方式对PEEP患者更适宜、更安全,并可有效避免风险。Objective To determine the effect on heart rate （HR）, non invasive blood pressure （NBP）, central venous pressure（CVP）, cardiac output（CO）, cardiac index （CI）,stroke ejection（SV）, left ventricle to function （LCW）, left ventricular stroke for power （LVSW）, pre-ejection period （PEP）, systolic time ratio （STR） and oth- ers for patients undergoing mechanical ventilation using PEEP open and closed suction Method Patients undergoing mechanical ventilation using PEEP from Jan 2009 to Oct, 2009 were randomly divided into closed suction （CS） and open suction （OS） group, the changing of the following indicators was observed,such as HR, NBP, CVP, CO, CI, SV, LCW, LVSW, PEP, LVET before the asoiration of sputum, after the suction immediately （PSI）, lminute after the suction （PSI） and 5 minutes after the suction（PS5）. And also the linear relalionship between the monitoring dates and the related baseline dates was analyzed. Result For patients undergoing OS, the measuring dates on HR, MAP,CVP, CO,CI,SV was significantly increased （P〈5.0.05）. For patients undergoing CS, the SBP and MAP was decreased significantly 1 minute after the suction, they remain below the baseline until 5 minutes after the suction. The CVP, CO, CI and SV was increased （P〉0.05）. Conclusion OS, CS could affect bemodynamic stability. In ordinary work, for patients undergoing mechanical ventilation using PEEP, attention should be paid to the secondary damage caused by the aspiration of sptum, to enhance monitoring of before and after suetioning. CS method was more suitable for patients using PEEP and also more secure and effective way to avoid risk.

关 键 词：密闭式吸痰 开放式吸痰PEEP 血流动力学 

分 类 号：R472[医药卫生—护理学]