密闭式与开放式吸痰在急诊ICU机械通气患者气道护理中的应用效果比较  

Comparison of application effects of closed and open sputum suction in airway nursing of patients with mechanical ventilation in emergency ICU

作　　者：许浩琴 张珊珊 张莹 XU Haoqin;ZHANG Shanshan;ZHANG Ying(Emergency Intensive Care Unit of Xuchang People’s Hospital,Xuchang 461000 Henan,China)

机构地区：[1]许昌市人民医院急诊重症监护室,河南许昌461000

出　　处：《中国民康医学》2024年第6期174-176,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较密闭式与开放式吸痰在急诊重症监护室(ICU)机械通气患者气道护理中的应用效果。方法:回顾性分析2021年1月至2022年1月该院ICU收治的76例机械通气患者临床资料,根据不同吸痰方式将其分为对照组和研究组各38例。对照组采用开放式气管内吸痰,研究组采用密闭式气管内吸痰。比较两组吸痰总量和机械通气时间,血气分析指标[动脉血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、呼吸频率、心率]水平,以及黏膜损伤发生率、呼吸机相关性肺炎(VAP)发生率。结果:研究组吸痰总量多于对照组,差异有统计学意义(P<0.05);两组机械通气时间比较,差异无统计学意义(P>0.05);两组SaO_(2)、PaO_(2)水平均高于吸痰前,且研究组高于对照组,两组PaCO_(2)水平均低于吸痰前,且研究组低于对照组,两组呼吸频率、心率均高于吸痰前,但研究组低于对照组,差异有统计学意义(P<0.05);研究组气道黏膜损伤发生率和VAP发生率均低于对照组,差异有统计学意义(P<0.05)。结论:密闭式气管内吸痰应用于ICU机械通气患者气道护理中,可提高吸痰总量,改善血气分析指标水平,以及降低气道黏膜损伤发生率和VAP发生率的效果优于开放式气管内吸痰效果。Objective:To compare application effects of closed and open sputum suction in airway nursing of patients with mechanical ventilation in emergency intensive care unit(ICU).Methods:The clinical data of 76 patients with mechanical ventilation admitted to the ICU of the hospital from January 2021 to January 2022 were retrospectively analyzed.According to different sputum suction methods,they were divided into control group and study group,38 cases in each group.The control group was treated with open endotracheal suctioning,while the study group was treated with closed endotracheal suctioning.The total amount of sputum suction and the mechanical ventilation time,the blood gas analysis indexes [arterial oxygen saturation(SaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),respiratory rate,heart rate] levels,the incidence of mucosal injury,and the incidence of ventilator-associated pneumonia(VAP) were compared between the two groups.Results:The total amount of sputum suction in the study group was more than that in the control group,and the difference was statistically significant(P<0.05).The levels of SaO_(2) and PaO_(2) in the two groups were higher than those before sputum suction,and those in the study group were higher than those in the control group;the PaCO_(2) levels of the two groups were lower than those before sputum aspiration,and that in the study group was lower than that in the control group;the respiratory rate and heart rate of the two groups were higher than those before sputum aspiration,but those in the study group were lower than those in the control group;and the differences were statistically significant(P<0.05).Further,the incidence of airway mucosal injury and VAP in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:The closed endotracheal suctioning in the airway nursing of the ICU patients with mechanical ventilation can increase the total amount of sputum su

关 键 词：急诊重症监护室 机械通气 气道护理 血氧饱和度 呼吸机相关性肺炎 

分 类 号：R473.5[医药卫生—护理学]