吸痰深度对成年人工气道患者吸痰效果影响的Meta分析  

Meta-analysis of the effect of suction depth in adult airway patients

作　　者：张勤 关甜晶 龚鑫 杨林 蒲萍 Zhang Qin;Guan Tianjing;Gong Xin;Yang Lin;Pu Ping(Department of Neurosurgery,the Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院神经外科,重庆400037

出　　处：《中华肺部疾病杂志（电子版）》2023年第3期335-339,共5页Chinese Journal of Lung Diseases(Electronic Edition)

摘　　要：目的分析深度吸痰及浅度吸痰对成年人工气道患者吸痰效果的影响。方法计算机检索Cochrane Library、PubMed、MEDLINE、EM-base、CINAHL、中国生物医学文献数据库、中国知网数据库(CNKI)、万方数据库、维普数据库(VIP)、中华医学期刊全文数据库中的深度及浅度吸痰对建立人工气道患者吸痰效果的随机对照实验,筛检纳入文献的参考文献。应用Cochrane评价员手册对文献质量进行评价,对符合质量标准的随机对照实验应用Rev Man5.3软件进行Meta分析。结果共22项随机对照试验,1795例患者参与研究。深度吸痰更有效,24 h吸痰次数更少[WMD=-2.09,95%CI:-2.61~-1.58,P<0.01],SaO_(2)增幅更大[WMD=-1.22,95%CI(-1.51,-0.94),P<0.001],痰鸣音改善评分无明显差异。浅吸痰有优势,浅吸痰时心率(HR)改变例数少[WMD=3.73,95%CI:2.41~5.77,P<0.00],呼吸(RR)增幅小[WMD=0.89,95%CI:0.64~1.15,P<0.001],血压(SBP)波动更小[WMD=3,95%CI(1.78,4.22),P<0.001],气道黏膜损伤[OR=8.54,95%CI(6.20,11.76),P<0.001]、刺激性呛咳[OR=5.01,95%CI(3.68,6.81),P<0.001]发生率小。结论深度吸痰有效性有效,可减少24 h吸引次数,SaO_(2)上升幅度更大,深度吸痰比浅度吸痰可能引起更大的心率、呼吸、血压的波动,气道损伤、呛咳发生率高,临床中应根据患者情况个性化选择吸痰深度。Objective To systematically evaluate the effect of deep and shallow sputum aspiration on sputum aspiration in adult patients with artificial airway.Methods Cochrane was searched by computer Randomized controlled studies of the effect of deep and shallow sputum aspiration on sputum aspiration in patients with artificial airway in Library,PubMed,MEDLINE,EM-Base,CINAHL,China Biomedical Literature Database,China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database and Chinese Medical Journal Full-text Database At the same time,the included literature was screened for references.Two researchers extracted the literature data,and evaluated the quality of the literature with the Cochrane evaluator manual.Meta-analysis was performed with Rev Man5.3 software for the randomized controlled trials that met the quality standards.Results A total of 22 randomized controlled trials involving 1514 patients were conducted.In terms of effectiveness,deep sputum aspiration was more effective,with fewer suctions per day,blood oxygen saturation increased more,but there was no significant difference in sputum sound improvement score.In terms of complications of sputum aspiration,shallow sputum aspiration had more advantages,with fewer cases of heart rate(HR)change and small increase in respiration(RR),lower fluctuation of blood pressure(SBP),airway mucosal injury[OR=8.54,95%CI(6.20,11.76),P<0.001]and irritating cough[OR=5.01,95%CI(3.68,6.81),P<0.001].Conclusions Depth of sputum suction in the sputum suction effectiveness is more effective,the depth of the sputum suction can decrease The Times of 24 h draw blood oxygen saturation rise is bigger,but in the sputum suction security,sputum suction depth than shallow sputum suction may cause greater fluctuations in heart rate,respiration,blood pressure,and high incidence of airway injury,choking cough,sputum suction can be personalized according to patients condition in clinical choice depth.

关 键 词：深度吸痰 浅度吸痰 人工气道 吸痰效果 

分 类 号：R563[医药卫生—呼吸系统]