不同体位对急性脑卒中患者吸痰效果的影响  

Influence of different body postures on sputum suctioning in patients with acute stroke

作　　者：钟运露[1] 李培珍[1] 刘远玲[1] 

机构地区：[1]广西医科大学第七附属医院,梧州543001

出　　处：《上海护理》2014年第6期5-8,共4页Shanghai Nursing

基　　金：广西梧州市科学技术局科研立项(201202014)

摘　　要：目的：探讨不同体位对急性脑卒中患者吸痰效果的影响。方法选择2012年4月—2014年5月在广西医科大学第七附属医院的急性脑卒中需吸痰患者64例，随机分为A组、B组和C组。 A组吸痰时取平卧位；B组吸痰时取侧卧位；C组吸痰时取侧卧位，头稍后仰并抬高床头15°～30°。比较3组患者对吸痰操作的耐受性，吸痰前和吸痰后2 min血压、心率、血氧饱和度、吸痰效果（吸痰间隔时间、痰鸣音改变情况、24 h吸痰量）以及气道黏膜损伤情况。结果与A组、B组比较， C组患者对吸痰耐受性最高、吸痰间隔时间最长、吸痰更彻底，气道黏膜损伤例次最少，组间比较差异具有统计学意义（P＜0．05）；C组患者吸痰后2 min血压、心率和血氧饱和度无明显变化，而A组、B组患者吸痰后2 min血氧饱和度明显下降，心率、血压（收缩压）明显升高，差异具有统计学意义（ P＜0．05）。结论对脑卒中患者采用侧卧位，头稍后仰并抬高床头15°～30°的体位吸痰能有效提高患者对吸痰操作的耐受性及吸痰效果，减少吸痰并发症及不良反应的发生，保持血流动力学的稳定，有利于患者的康复。Objective To investigate the influence of three kinds of body postures on sputum suctioning in the patients with acute stroke .Methods A total of 64 cases of acute stroke with ineffective airway clearance requi-ring sputum suctioning in The 7 th Affiliated Hospital of Guangxi Medical University from April 2012 to May 2014 were chosen.They were randomly divided into groups A , B and C.The patients in group A took supine position, in group B took lateral position , and in group C took lateral position with head backward slightly and head of bed elevated 15-30 degrees .The patient tolerance to sputum suctioning , effect of sputum suctioning （ time interval , sound changes , and 24 h sputum volume ） , airway mucous membrane injury , and blood pres-sure , heart rate and oxygen saturation before and 2 min after suctioning were compared among three groups .Re-sults Compared with groups A and B , group C had the highest tolerance to sputum suctioning , longest time in-terval, most thorough suctioning , and fewest airway mucosal injury cases （P〈0.05）.2 min after suctioning, there were no significant changes in the blood pressure , heart rate and oxygen saturation in group C .However , in groups A and B , the oxygen saturation decreased significantly , and heart rate and blood pressure （ systolic blood pressure ） increased significantly （ P 〈0.05 ） .Conclusion The lateral position with head backward slightly and head of bed elevated 15-30 degrees can effectively improve the patient tolerance to sputum suctio-ning and the effect of sputum suctioning in the patients with acute stroke .It can also reduce the complications of sputum suctioning and the incidence of adverse events , maintain hemodynamic stability , and reduce the risk ofstroke recurrence .

关 键 词：急性脑卒中 吸痰 体位 

分 类 号：R473.74[医药卫生—护理学]