不同吸痰深度对高血压脑出血气管切开患者血氧饱和度的影响  

Effect of different sputum suction depths on blood oxygen saturation in patients with hypertensive cerebral hemorrhage and tracheotomy

作　　者：于士艳 王爱凤[1] 黄焱 刘莉莉 葛慕莲 YU Shiyan;WANG Aifeng;HUANG Yan;LIU Lili;GE Mulian(Department of Neurosurgery,Huai’an First People’s Hospital,Huai’an Jiangsu 223300,China)

机构地区：[1]淮安市第一人民医院神经外科,江苏淮安223300

出　　处：《临床与病理杂志》2022年第12期2905-2911,共7页Journal of Clinical and Pathological Research

摘　　要：目的:探讨不同吸痰深度对高血压脑出血气管切开患者血氧饱和度的影响。方法:选取2020年1月至2022年1月淮安市第一人民医院收治的高血压脑出血行气管切开术的70例患者,所有患者均在气管切开术后第2天进行深部、浅部吸痰各4次,比较不同吸痰深度吸痰前后患者脉搏血氧饱和度(pulse oxygen saturation,SpO_(2))、脑组织血氧饱和度(cerebral tissue oxygen saturation,rSO_(2))水平的变化情况。结果:深部与浅部吸痰后即刻SPO_(2)水平均低于吸痰前1 min(均P<0.05),吸痰后3、5、10 min的SpO_(2)水平均高于吸痰前1 min(均P<0.05);深部与浅部吸痰相比,吸痰前后各时间点SPO_(2)水平差异均无统计学意义(均P>0.05)。深部与浅部吸痰后各时间点的rSO_(2)水平均高于吸痰前1 min(均P<0.05);深部与浅部吸痰相比,吸痰前后各时间点rSO_(2)水平差异均无统计学意义(均P>0.05)。患者血压水平在吸痰后首先增高再逐渐下降至吸痰前1 min水平,深部、浅部吸痰患者血压变化规律类似,且深部吸痰患者吸痰后5 min恢复至吸痰前水平,浅部吸痰患者吸痰3 min恢复至吸痰前水平,吸痰3 min内深部吸痰相较于浅部吸痰患者血压增加更明显(P<0.05)。结论:深部吸痰、浅部吸痰应用于高血压脑出血气管切开术患者的吸痰效果一致,且对血氧饱和度的影响无明显差异,临床建议实施浅部吸痰,以减少不良反应的发生。Objective:To investigate the effect of different sputum suction depths on blood oxygen saturation in patients with hypertensive cerebral hemorrhage and tracheotomy.Methods:From January 2020 to January 2022,70 patients with hypertensive cerebral hemorrhage who underwent tracheotomy in Huai’an First People’s Hospital were selected.All patients underwent deep and shallow sputum suction each for 4 times on the 2nd day after tracheotomy,and the changes of pulse oxygen saturation(SpO_(2))and cerebral tissue oxygen saturation(rSO_(2))levels before and after suction at different sputum suction depths were compared.Results:The SpO_(2)levels immediately after suction were lower than 1 min before suction in patients with deep and shallow sputum suction(both P<0.05),while the SpO_(2)levels at 3,5,and 10 min after suction were all higher than that 1 min before suction(all P<0.05).There was no statistically significant difference in SpO_(2)levels at all time points between patients with deep and shallow sputum suction(all P>0.05).The rSO_(2)levels at all time points after suction were higher than that 1 min before suction in patients with deep and shallow sputum suction(all P<0.05).There was no statistically significant difference in rSO_(2)levels at all time points between patients with deep and shallow sputum suction(all P>0.05).The blood pressure levels of patients first increased after sputum suction and then gradually decreased to the level 1 min before sputum aspiration.The changes in blood pressures of patients with deep and shallow suction had similar patterns.Patients with deep sputum suction returned to pressure levels before suction at 5 min after suction,while those with shallow sputum suction returned to pressure levels before suction at 3 min after suction.Elevation of blood pressures within 3 min after suction was more obvious in patients with deep sputum suction compared with those with shallow sputum suction(P<0.05).Conclusion:Deep and shallow sputum suction have the same effect on patients with hypertensi

关 键 词：深部吸痰 浅部吸痰 高血压脑出血 气管切开 血氧饱和度 

分 类 号：R743.34[医药卫生—神经病学与精神病学]