急性呼吸窘迫综合征机械通气患者吸痰致低氧血症的预防研究进展  

Research progress on prevention of hypoxemia caused by sputum aspiration in patients with ARDS undergoing mechanical ventilation

作　　者：杨荀 张灵 刘黎[1] 马文娟 文富强[1] YANG Xun;ZHANG Ling;LIU Li;MA Wenjuan;WEN Fuqiang(Department of Respiratory and Critical Care Medicine,West China Hospital of Sichuan University,Chengdu Sichuan 610041,China)

机构地区：[1]四川大学华西医院呼吸与危重症医学科,四川成都610041

出　　处：《中国急救复苏与灾害医学杂志》2024年第7期960-964,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：四川大学华西医院1·3·5高端人才支持计划项目(编号:ZYGD23009)。

摘　　要：急性呼吸窘迫综合征(ARDS)是指心源性以外各种肺内外致病因子导致的急性进行性Ⅰ型缺氧性呼吸衰竭,病情进展快,预后较差。机械通气是治疗ARDS的首要手段,可有效改善患者的氧合功能。吸痰是ARDS患者在机械通气治疗时用来保持呼吸道通畅的一项重要护理操作,对肺泡正常通气和氧合功能的改善具有重要意义,但吸痰过程中因操作对患者气道易引起物理刺激和气道压力改变,极易引发低氧血症,对ARDS转归不利,故而为确保ARDS机械通气治疗中的吸痰安全,避免患者低氧血症的发生,临床多有学者提出不同的预防措施,通过本文综述对临床ARDS吸痰致低氧血症的预防措施进行总结和归纳,为临床提供了更为清晰的诊疗思路。Acute respiratory distress syndrome(ARDS) is an acute and progressive type I hypoxic respiratory failure caused by various external and internal pulmonary pathogenic factors other than cardiogenic factors,with rapid disease progresses and poor prognosis.Mechanical ventilation is the first choice for ARDS,which can effectively improve oxygenation function of patients.Sputum aspiration is an important nursing operation for ARDS patients to maintain airway patency during mechanical ventilation,which is of great significance for normal alveolar ventilation and improvement of oxygenation function.However,physical stimulation and changes of airway pressure during sputum aspiration are easy to cause hypoxemia,which is detrimental to ARDS outcomes.Therefore,in order to ensure the safety of sputum aspiration and avoid the occurrence of hypoxemia in ARDS patients after mechanical ventilation,many clinical scholars have proposed different preventive measures.This article summarizes and concludes the preventive measures of hypoxemia induced by sputum aspiration so as to provide more clear clinical diagnosis and treatment ideas.

关 键 词：急性呼吸窘迫综合征 机械通气 吸痰 低氧血症 研究进展 

分 类 号：R563.8[医药卫生—呼吸系统]