滴注NaCl湿化液对机械通气新生儿吸痰效果及心肺功能的影响  

Effect of saline instillation on endotracheal suction for neonates with mechanical ventilation

作　　者：王娟[1] 蓝宇涛[1] 李于凡[2] 

机构地区：[1]广东药学院护理学院基础护理学教研室,广州510310 [2]广州医学院附属第三医院NICU,510150

出　　处：《中华现代护理杂志》2012年第23期2751-2754,共4页Chinese Journal of Modern Nursing

基　　金：广东省医学科研基金立项课题（A2009314）;广东省高等学校本科特色专业建设点资助项目（粤教高函[2010]96号）

摘　　要：目的探讨机械通气新生儿吸痰前气道内滴注不同容量、浓度的NaCl湿化液对痰量和心肺功能的影响。方法选择20例有创机械通气新生儿，分别给予气道内滴注不同容量、浓度的NaCl湿化液，记录滴注湿化液后和吸痰后1，2，10min的痰量和外周血氧饱和度（SpO2）、气道峰压（PIP）、心率（HR）、收缩压（SBP）和舒张压（DBP）。结果滴注0.5ml湿化液组的痰液排出量（1.27±0.77）ml与不滴注湿化液组的痰液排出量（0.74±0.55）ml比较，差异有统计学意义（P=0.006），但与滴注1ml湿化液组的痰液排出量（0.99±0.66）ml比较，差异无统计学意义（P=0.072）。在气管内吸痰前滴注不同浓度（0.9%和0.45%）、不同容量（0.5ml和1ml）NaCl湿化液对痰液排出量的影响无统计学差异（P＞0.05）。不同浓度和容量的NaCl湿化液对SpO2、HR、PIP、SBP和DBP均无影响（P＞0.05），但SpO2、HR和SBP在吸痰前后均有随时间变化的趋势（F值分别为41.567，39.688，6.715，P＜0.05）。吸痰后2，10min的SpO2高于滴注湿化液后和吸痰后1min；吸痰后1，2min的HR快于滴注湿化液后；吸痰后1，2min的SBP较滴注湿化液后增高；PIP和DBP在吸痰前后没有随时间变化的趋势。结论机械通气新生儿吸痰前气道内滴注0.5ml、0.9%NaCl湿化液，可以增加痰量，对心肺功能无明显不良影响。Objective To explore the effects of saline instillation on sputum and cardiopulmonary functions of neonates with mechanical ventilation when endotracheal suctioning. Methods Totals of 20 neonates with mechanical ventilation were recruited. Saline instillation was implemented before endotracheal suction at different doses and concentrations. Sputum and cardiopulmonary parameters were recorded after saline instillation and 1 minute, 2 minutes, 10 minutes after suctioning, including SpO2, PIP, HR, SBP and DBP. Results The 0.5 ml saline instillation group has more sputum than that of no saline instillation group, and the difference was statistically significant [ （ 1.27 ± 0. 77 ） ml vs （0.74 ± 0. 55 ） ml ; P = 0. 006 ], while no significant difference was found between 0.5 ml saline instillation group and 1.0 ml saline instillation group [ （ 1.27 ± 0.77） ml vs （ 0. 99 ± 0. 66 ） ml; P = 0. 072 ]. There was no significant effect of the different dose and concentration of saline instillation on sputum of the neonates （ P 〉 0.05 ） and on the cardiopulmonary parameters （P〉0. 05）. SpO2, HR and SBP were significantly changed with time （F = 41. 567,39. 088,6. 715, respectively ;P 〈 0.05）. SpO2 in the points of 2 minute and 10 minute after suctioning were higher than that in the points of saline instillation and 1 minute after suction; HR in the points of 1 minute and 2 minute after suctioning were higher than that in the point of saline instillation; SBP in the points of 1 minute and 2 minute after suctioning were higher than that in the points of saline instillation and 1 minute after suction. PIP and DBP were not significantly changed with time （ P 〉 0.05 ）. Conclusions Instillation of 0.5 ml normal saline in neonates with mechanical ventilation when endotracheal suctioning may increase sputum and have little side effects on cardiopulmonary function.

关 键 词：新生儿 机械通气 气管内吸痰 滴注NaCl液 

分 类 号：R472[医药卫生—护理学]