全麻术后患者不吸痰拔除导管的心血管应激反应观察  

Observation on cardiovascular stress response of catheter removal without sputum aspiration in patients undergoing general anesthesia operation

作　　者：陈宏英[1] 张玉杰[1] 白金猛[1] 鲍丽娜[1] 刘学双[1] 

机构地区：[1]河北省秦皇岛市第一医院麻醉科,066000

出　　处：《职业与健康》2014年第4期566-568,共3页Occupation and Health

摘　　要：目的探讨不吸痰对全麻患者拔除气管导管的安全性。方法 108例静吸复合全麻患者,手术结束后送入麻醉恢复室。依患者情况给予常规吸痰护理,待清醒时拔除气管导管,随机分成两组,A组清醒时吸痰后拔除导管(n=50例),B组清醒时不再吸痰直接拔管(n=58例)。以患者呼之睁眼,应答正确,配合动作,握拳有力,脱氧10 min血氧饱和度维持在95%以上为拔管指标,观察拔管前、拔管即刻、拔管后3和10 min时的心血管反应,确定不吸痰的安全可行性。结果 A组、B组拔管即刻、拔管后3 min的血压、心率与拔管前相比均升高;A组患者血氧饱和度在拔管即刻、拔管后3 min时较拔管前有所降低,两组相比,差异有统计学意义。结论在不吸痰的情况下,清醒后直接拔除气管导管,避免了患者拔管后的缺氧,减少了患者的心血管应激反应。[ Objective] To explore the safety of catheter removal without sputum aspiration in patients undergoing general anesthesia operation. [ Methods] 108 patients undergoing intravenous-inhalation combined anesthesia were collected after operation. The pa- tients were given the conventional sputum suction nursing, and received the catheter removal when they were awakened. The pa- tients were randomly divided into two groups ： group A received the catheter removal after sputum aspiration （ 50 cases }, and group B received the catheter removal without sputum aspiration （ 58 cases ）. The extubation indicator was patient can open eyes when hearing his/her name, answer correctly, cooperate the movement, clench hands powerfully, and the oxyhemoglobin saturation maintains over 95% after removing inspired oxygen for 10 min. The cardiovascular stress responses before catheter removal, at the moment of catheter removal, 3 and 10 min after catheter removal were observed, to determine the feasibility of catheter removal without sputum aspiration. [ Results ] In group A and group B, the blood pressure and heart rate at the moment of catheter removal and 3 min after catheter removal increased as compared with those before catheter removal. The oxyhemoglobin saturation at the mo- ment of catheter removal and 3 min after catheter removal in group A was lower than that before catheter removal. The differences were significant. [ Conclusion ] Without sputum aspiration, carrying out catheter removal directly when patients are awakened can a- void hypoxia after catheter removal, and reduce the cardiovascular stress responses.

关 键 词：全麻 术后 不吸痰拔管 心血管反应 

分 类 号：R614.2[医药卫生—麻醉学]