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机构地区:[1]广东省汕头市第二人民医院,515011 [2]广东省人民医院心脏外科复苏室
出 处:《中国实用护理杂志》2011年第11期14-17,共4页Chinese Journal of Practical Nursing
基 金:基金项目:广东省汕头市重点科技计划项目{汕府科[2006]82号之[4]
摘 要:目的探讨正压通气拔除气管插管(简称拔管)对心内直视术后患者动脉血气分析指标的影响。方法将50例行心内直视术后经口气管插管的患者,随机分为对照组和实验组各25例。对照组采用传统拔管法,实验组则采取在患者吸气期给予5~25cmH2O纯氧正压通气,于呼气期拔管。比较2组患者拔管前、拔管后1,5,10min的PaO2、PaCO2、SaO2、动脉血pH值和RR变化,同时观察拔管期间呼吸道梗阻情况。结果拔管后2组患者动脉血气分析指标在各对应时点进行比较,实验组变化的幅度明显低于对照组,且变化的持续时间缩短50%以上。拔管后对照组发生呼吸道梗阻4例,实验组未发生呼吸道梗阻,2组比较有明显差异。结论正压通气拔管法能提高肺顺应性,改善氧合,使患者拔管后各项动脉血气分析指标较为平稳,降低低氧血症的发生率,是一种比较安全的拔管方法。Objective To study the effect of positive pressure ventilation extubation on arterial blood gas indexes of patients undergoing cardiac surgery. Methods 50 patients with orotraeheal intubation after intracardiac opening operation under direct vision were randomly divided into the control group and the experimental group with 25 cases in each group. We used traditional method to pull out tracheal intubation in the control group. And positive pressure ventilation at 5-15 cm H2O during inspiration and pulling out tracheal intubation during expiration in the experimental group. The change of arterial blood PaO2, PaCO2, SaO2, p H and respiratory rate before and 1 min,5min, 10min after extubation was observed, and also the incidence rate of air tube obstruction was recorded. Results The change amplitude of arterial blood gas indexes of patients in the experimental group was obviously lower,and the length of change time reduced more than 50%. There were 4 air tube obstructions in the control group and there was no obstruction in the experimental group. The difference was statistically significant. Conclusions Positive pressure ventilation extubation can raise lung's compliance and improve oxygenation. And arterial blood gas indexes are more stable. It can decrease the incidence rate of hypoxemia and is a much more safe method.
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