不同吸痰方式对颅脑损伤气管切开患者气道分泌物清除的效果观察  

Effect of different endotracheal suctioning methods on clearance of airway secretions in patients with craniocerebral injury and tracheotomy

作　　者：安德连[1] 戴萌[1] 卫小梅[1] 唐志明[1] 许自阳 温红梅[1] 窦祖林[1] AN Delian;DAI Meng;WEI Xiaomei;TANG Zhiming;XU Ziyang;WEN Hongmei;DOU Zulin(Department of Rehabilitation Medicine,The Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou,Guangdong,510630)

机构地区：[1]中山大学附属第三医院康复科,广东广州510630

出　　处：《中西医结合护理》2023年第6期127-131,共5页Chinese Journal of Integrative Nursing

基　　金：广东省医学基金(面上项目)(A2020129)。

摘　　要：目的探讨吸唾管结合吸痰管吸痰法在颅脑损伤气管切开患者中的应用效果。方法采用随机对照试验研究方法,对符合纳入标准的106例颅脑损伤气管切开后住院患者,根据随机数字表法分为两组,每组53例。对照组采用吸痰管常规吸痰法进行治疗和护理,试验组采用吸唾管结合吸痰管吸痰法进行治疗和护理。比较两组患者吸痰前后的电子喉镜吞咽功能评估(FEES)下分泌物严重程度分级;两组患者入院后第1、3、7天的吸痰次数、吸痰前后1min血氧饱和度及心率变化情况,观察两组住院患者第1、3、7天电子软管支气管镜下黏膜破损情况。结果试验组吸痰后电子喉镜吞咽功能评估(FEES)分泌物严重程度分级低于对照组,差异具有统计学意义(P<0.05)。试验组吸痰前1min的血氧饱和度与对照组比较,差异无统计学意义(P>0.05);吸痰后的血氧饱和度高于对照组,差异有统计学意义(P<0.05)。试验组吸痰前1 min的心率与对照组比较,差异无统计学意义(P>0.05);吸痰后1min的心率低于对照组,差异有统计学意义(P<0.05)。试验组吸痰次数低于对照组,差异有统计学意义(P<0.05)。黏膜破损总发生率低于对照组,差异有统计学意义(P<0.05)。结论吸唾管结合吸痰管吸痰法的气道分泌物清除效果明确,减轻患者痛苦,且并发症较少,显著降低了气道黏膜损伤的发生率,安全性较高。Objective To investigate the effect of endotracheal suctioning method using suctioning sputum with suctioning salivary tube in patients with craniocerebral injury undergoing tracheotomy.Methods A randomized controlled trial was conducted in 106 patients with traumatic brain injury after tracheotomy who met the inclusion criteria.According to the random number table method,they were divided into two groups,with 53 cases in each group.The experimental group was treated with endotracheal suctioning method using sputum suction tube combined with sputum suction tube,while the control group was treated with routine sputum suction method using sputum suction tube.The secretion severity grade under electronic laryngoscope swallowing function assessment(FEES)before and after sputum aspiration was compared between the two groups.The number of sputum aspiration,blood oxygen saturation and heart rate changes at 1 minute before and after sputum aspiration were observed in the two groups at 1,3 and 7 days after admission.The mucosal damage under electronic hose bronchoscopy was observed in the two groups at 1,3 and 7 days after admission.Results The severity of FEES was significantly lower in the experimental group than in the control group(P<0.05).There was no significant difference in blood oxygen saturation between the experimental group and the control group one minute before sputum aspiration(P>0.05).The blood oxygen saturation after sputum aspiration was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in heart rate between the experimental group and the control group 1 minute before sputum aspiration(P>0.05).The heart rate one minute after sputum aspiration was lower than that of the control group,and the difference was statistically significant(P<0.05).The number of sputum aspiration in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).The total incidence of mucosal da

关 键 词：颅脑损伤 吸痰 气管切开术 吞咽障碍 气道护理 

分 类 号：R473.6[医药卫生—护理学]