重型颅脑损伤患者气管切开早期采取不同吸痰方式的效果研究  

The effects of different suctioning methods in patients with severe brain injuries at the early stage of tracheotomy

作　　者：崔君霞[1] 金奕[1] 于华[1] 

机构地区：[1]天津中医药大学研究生院,天津市300193

出　　处：《中华护理杂志》2013年第2期124-126,共3页Chinese Journal of Nursing

摘　　要：目的研究不同吸痰方法对重型颅脑损伤患者气管切开早期肺通气功能及肺部感染的影响。方法采取临床随机对照试验研究,对符合纳入标准的70例重型颅脑损伤患者,按入院顺序编号,并根据随机数字表法,分为两组,每组35例。试验组在气管切开早期采取纤维支气管镜吸痰与浅部吸痰相结合的优化吸痰法,对照组35例在气管切开早期采取常规吸痰法。分析两组患者在气管切开早期黏膜出血、肺部感染发生率及血气分析的变化情况。结果两组患者气管切开早期血气分析结果经重复测量方差分析,试验组动脉血压分压、氧合指数显著高于对照组(P<0.05),动脉二氧化碳分压显著低于对照组(P<0.05)。试验组7例(20.00%)发生黏膜出血,对照组31例(88.57%)发生黏膜出血;试验组11例(31.42%)发生肺部感染,对照组23例(65.71%)发生肺部感染;两组比较,差异均有统计学意义(P<0.05)。结论与临床常规吸痰方法相比,采用纤维支气管镜结合浅部吸痰的优化吸痰方式可降低重型颅脑损伤气管切开早期患者肺部感染发生率,维持肺部正常通气功能,提高气道管理水平,改善患者预后。Objective To investigate the impact of different suctioning methods on the pulmonary functions and incidence of pneumonia in patients with severe traumatic brain injuries at the early stage of tracheotomy. Methods Seventy severe brain injuries patients with tracheotomy were randomly divided into two groups, 35 in each group. The patients in the experi- mental group received bronchoscopy combined with shallow suctioning, while the patients in the control group received con- ventional suctioning. The incidence of pneumonia, airway mucosal hemorrhage, and the results of blood gas analysis were compared between the two groups. Results The results of blood gas analysis showed that the levels of PaO2 and PaO：JFiO~ in the experimental group were significantly higher than that of the control group（P〈O.05）, while the level of PaC02 was significantly lower than that of the control group （P〈0.05）. The incidence of airway mucosal hemorrhage in the experimental group was sig nificantly lower than that of the control group（20.00% vs. 88.57%,P〈0.05）, the incidence of pneumonia in the experimental group was also significantly lower than that of the control group（31.42% vs. 65.71%,P〈0.05）. Conclusion The bronchoscopy combined with shallow suctioning method can reduce the incidence of pneumonia, maintain the normal pulmonary ventilation functions and improve patient outcomes.

关 键 词：颅脑损伤 吸痰 气管切开术 护理 

分 类 号：R473.6[医药卫生—护理学]