持续性膨肺在长期机械通气患者开放式吸痰后的应用  

Application of Sustained Inflation after Open-loop Aspiration of Sputum on Patients with Long-term Mechanical Ventilation

作　　者：宋晓莉[1] 朱海燕[1] 张娟[1] 刘杰[1] 黎檀实[1] 

机构地区：[1]解放军总医院急诊科,北京100853

出　　处：《临床误诊误治》2012年第11期45-47,共3页Clinical Misdiagnosis & Mistherapy

基　　金：解放军总医院科技创新苗圃基金面上项目课题(09KMM53);国家自然科学基金青年基金项目(30900543)

摘　　要：目的观察持续性膨肺(sustained inflation,SI)在长期机械通气患者开放式吸痰后的应用效果。方法选择我院急诊ICU收治的建立人工气道需长期行机械通气治疗9例,在实施开放式吸痰后进行SI治疗,观察其对患者生命体征及动脉血气分析结果的影响。结果 9例6次SI治疗后血气分析结果,除第1次SI治疗后乳酸水平与SI治疗前比较差异有统计学意义(P<0.05),余各次各项血气分析指标与SI治疗前相应指标比较差异均无统计学意义(P>0.05)。SI治疗1周后9例生命体征平稳,胸痛均缓解,胸部X线检查示肺不张明显好转;心动过速明显缓解,与治疗前比较差异有统计学意义(P<0.05);体温恢复正常,与治疗前比较差异亦有统计学意义(P<0.05)。结论长期机械通气患者在开放式吸痰后给予SI治疗,可使萎陷的肺泡复张,降低肺不张发生率。Objective To observe effect of sustained itfflation （SI） after open-loop aspiration of sputum on patients with long-term mechanical ventilation. Methods Nine patients with long-term mechanical ventilation by artificial airway in ICU of department of emergency were recruited. SI treatment was applied after open-loop endotracheal suction and the patients＇vital signs and arterial blood gas were analyzed. Results The results of 9 patients＇arterial blood gas after 6 rounds of SI treatment were of no statistical significance before and after SI treatment in blood gas analysis index for the other 5 rounds （ P 〉 0. 05 ） except the level of lactic acid before and after the first round of SI treatment was significantly different （ P 〈 0. 05 ）. Nine patients showed stable vital signs, catabatic chest pain, improved atelectasis by thoracic roentgenoscopy and tachycardia were alleviated, and the differences before and after treatment were of statistical significance （P 〈 0. 05 ）. Temperature returned to normal, and the difference before and after treatment was also of statistical significance （P 〈 0. 05）. Conclusion SI may help alveolar recruitment and reduce incidence rate of atelectasis in patients with long-term mechanical ventilation after open-loop aspiration of sputum.

关 键 词：呼吸 人工 吸痰 膨肺 

分 类 号：R459.7[医药卫生—急诊医学]