声门下滞留物pH值测定在机械通气患者反流误吸评估中的应用与探讨  

Applied research of pH value determination of subglottic entrainment in evaluation of reflux aspiration in mechanically ventilation patients

作　　者：徐吉涛 庄耀宁 黄美春[1] 甘香[1] 谢颖彬[1] XU Jitao;ZHUANG Yaoning;HUANG Meichun;GAN Xiang;XIE Yingbin(The Affiliated Hospital of Putian University,Putian Fujian 351100)

机构地区：[1]莆田学院附属医院,福建莆田351100

出　　处：《天津护理》2020年第2期130-133,共4页Tianjin Journal of Nursing

摘　　要：目的:通过检测分析胃内容物反流患者声门下滞留物的pH值,并与相应的食道pH值对比分析,探究二者的统计学相关性,为临床重症患者反流误吸评估提供简单、易操作的监测手段。方法:选取2018年2月至2018年12月32例在人工气道下进行机械通气的患者,测定其声门下滞留物的pH值,对其临床资料进行对比观察,分析其声门下滞留物pH值与胃内容物反流的相关性。结果:经测定发现,当食道pH值为3.5~5.5时,对应的声门下滞留液pH值全部在4.4~6.6,且声门下滞留液pH值与食道pH值存在明显的线性关系,相关系数r=0.976,t=13.536,P<0.001;进一步线性回归分析,声门下滞留液pH值与食道pH值的关系为y=0.9602x+1.2104,决定系数R^2=0.9812,即二者呈线性正相关。结论:声门下滞留物的pH值与食管的pH值存在统计学的线性正相关,临床上可通过测定声门下滞留物pH值来预测评估患者是否发生胃内容物反流,及时采取干预措施,预防误吸的发生。Objective:To explore the statistical correlation between pH value of subglottic entrainment of gastric contents and esophagus in patients with reflux,and to provide a simple and easy monitoring method for the evaluation of reflux aspiration in severe clinical patients.Methods:32 mechanical ventilation patients with artificial airway from February to December 2018 were selected to determine the pH value of their subglottic retention,and their clinical data were compared.The correlation was analyzed between the pH value of their subglottic retention and gastric contents reflux.Results:It was found that when the pH value of esophagus was 3.5~5.5,the pH value of the corresponding subglottic retained fluid was all 4.4~6.6,and there was a significant linear relationship between the pH value of the subglottic retained fluid and the pH value of the esophagus(r=0.976,t=13.536,P<0.001).Further linear regression analysis showed that there was a positive linear correlation between the pH value of the subglottic retention and esophagus(y=0.9602x+1.2104,R^2=0.9812).Conclusion:There is a statistically positive linear correlation between pH value of subglottic entrails and pH value of esophagus.In clinical practice,the pH value of subglottic entrails can be measured to predict and evaluate whether gastric contents reflux occurs in patients,and timely intervention measures can be taken to prevent aspiration.

关 键 词：反流 误吸 食管PH监测 声门下滞留物pH值 机械通气 

分 类 号：R47[医药卫生—护理学]