连接负压拔管术在气管导管拔出中的应用  

Application of extubating with negative pressure suction in endotracheal tube extubation

作　　者：姚文建[1] 许婷[1] 杜锡荣[1] 

机构地区：[1]四川省医学科学院四川省人民医院麻醉科,成都610072

出　　处：《中国实用护理杂志》2012年第26期29-31,共3页Chinese Journal of Practical Nursing

摘　　要：目的观察全身麻醉后气管导管拔除时气管导管连接负压直接拔管的可行性、安全性及效果。方法选择无呼吸系统疾病史、无困难气道和通气困难、ASAⅠ-Ⅱ级（无或有轻度系统性疾病，但对日常工作和生活无影响）、18-65岁择期气管内全身麻醉患者86例，随机分成A、B2组各43例。拔管前A组：不用吸痰管，直接连接负压于气管导管体外端；B组：用吸痰管插入气管导管内吸引。观察2组拔管前后MAP、HR、ECG、SpO2，记录拔管后咳嗽咳痰情况及心电图和并发症发生情况。结果与自身拔管前比较A组拔管后MAP、HR稍有升高，SpO2稍有下降，ECG无异常，但无显著差异；B组拔管后MAP、HR、SpO2较自身拔管前比较有显著差异，且与同期A组比较也有显著差异。结论连接负压拔管能有效减轻心血管反应，避免缺氧，减少气管、支气管损伤及肺部并发症，实用性强，是气管导管拔除法中值得推荐的一种好方法。Objective To investigate the feasibility, safety and efficacy of tracheal extubation with directly connected negative pressure suction. Methods 86 patients with I or II degree of ASA, aged 18- 65 years old, without history of respiratory disease, difficult airway and ventilation problems were involved in this study. All patients undergoing endotracheal general anesthesia were randomly divided into group A and B with 43 cases in each group. Group A used negative pressure directly connected to external side of the endotracheal tube before extubation. Group B used suction tube putting into the endotracheal tube be- fore extubation. MAP, HR, ECG, SpO2, the condition of cough and expectoration and complicatons after ex- tubation were recorded. Results In group A the MAP, HR slightly increased, SpO2 slightly decreased, ECG showed no significant change, but the differences were not significant. In group B, MAP, HR,SpO2 showed significant difference compared with those before extubation and the corresponding period of group A. Conclusions The method that connecting negative pressure suction with endotracheal tube can effec- tively reduce the cardiovascular response during extubation, It also can avoid hypoxia, reduce the tracheo- bronchial injury and pulmonary complications. It＇s a practical good method in tracheal extubation.

关 键 词：连接负压 气管内吸痰 气管导管拔出 方法 并发症 

分 类 号：R614[医药卫生—麻醉学]