两种吸痰方式在胸外科气管插管机械通气患者护理中的应用  

Discussion of two types of sputum suction nursing in thoracic surgery patients with tracheal intubation and mechanical ventilation

作　　者：范丽丽[1] 王小敏[1] 秦彦骅 

机构地区：[1]上海交通大学附属瑞金医院普胸外科,上海市200025

出　　处：《护理实践与研究》2015年第4期65-67,共3页Nursing Practice and Research

摘　　要：目的：探讨两种吸痰方式对胸外科机械通气患者呼吸机相关性肺炎、痰液黏稠度及吸痰间隔时间的影响。方法：选择2012年3月～2014年3月行气管插管机械通气患者56例，将患者随机分为观察组27例和对照组29例。对照组按传统方法每2 h 气管导管内滴注生理盐水1～2 ml 后吸痰，观察组按吸痰指征吸痰，不使用生理盐水进行气道湿化。48 h 后观察两组患者呼吸机相关性肺炎（VAP）的发生率、痰液黏稠度、吸痰间隔时间。结果：观察组患者 VAP 发生率低于对照组（P 〈0．05），吸痰间隔时间长于对照组（P 〈0．05），两组患者痰液黏稠度差异无统计学意义（P 〉0．05）。结论：按吸痰指征吸痰，不使用生理盐水进行气道湿化吸痰方式可显著减少 VAP 发生率，延长两次吸痰间隔时间，值得在临床推广使用。Objective：To explore the application of two types of sputum suction in thoracic surgery in ventilator associated pneumonia in patients with me-chanical ventilation,sputum viscosity,and the influence of the frequency of sputum suction to the nurse. Methods：The study included 56 patients from March 2012 to March 2014 underwent tracheotomy and mechanical ventilation patients. The patients were randomly divided into observation group of 27 ca-ses and control group of 29 cases. The control group according to traditional methods of each 2 hours of endotracheal tube infusion of saline 1 to 2 ml after sputum aspiration,while the observation group according to sputum suction of pointer airway humidification without using physiological saline. The incidence of ventilator - associated pneumonia（VAP）,sputum viscosity and nurse suction interval frequency changes were observed after 48 hours. Results：The inci-dence of VAP in observation group was lower than the control group（P 〈 0. 05）. The two groups had no statistically significant difference in sputum viscosity （P 〉 0. 05）. The study group of sputum suction time interval was longer than the control group（P 〈 0. 05）. Conclusion：The observation group of sputum suction can reduce the incidence of VAP,extend the two suction times interval though no significant difference in sputum viscosity. It is worthy of clinical ap-plication.

关 键 词：气管插管 机械通气 吸痰方式 应用效果 

分 类 号：R473.6[医药卫生—护理学]