经鼻气管内吸痰法在肺心病急性加重期患者中的应用研究

The application of sputum suction by tracheal intubation via nasal approach on the patients with acute deteriorating cor pulmonale

目的探讨经鼻气管内吸痰方法在慢性肺心病急性加重期患者中的应用及其吸痰较果。将在我院住院治疗的慢性肺心病急性加重期患者100例随机分为观察组（50例）与对照组（50例）观察组采用经鼻气管内吸痰方法吸痰，对照组采用经鼻腔／口腔直接吸痰法（常规吸痰法）观察两种吸痰方法对24h吸痰次数和吸痰总量、黏膜损伤的发生及对血氧饱和度和心肌耗氧量的影响。结果观察组吸痰次数和总量、黏膜损伤的发生及吸痰方法对血氧饱和度和心肌耗氧量的影响与对照组相比均有显著性差异（P〈0．05）。实验组吸痰后与吸痰前比较HR、SBP和心肌耗氧量显著降低，差异有统计学意义（P〈0．05）吸痰后实验组Sp02高于对照组（P〈0．05）。结论气管内吸痰法效果明显优于传统吸痰法。能彻底清除潴留的痰液，改善通气功能，减轻吸痰所致的低氧血症和气道黏膜损伤，降低心肌耗氧量，提高血氧饱和度。

Objective To explore the application and effect of sputum suction by tracheal intubatlon via nasal approach on patients with acute deteriorating chronic cor - pulmonale. Methods A total of 100 cases of patients with acute deteriorating chronic cur - p, lmonale in our hospital were randomly divided into observation group （ 50 cases ） and control group （50 cases ）. The observation group was received sputum suction by tracheal intubation via nasaL Control group was sputum drainage via nasal directly. The times and the quantity of sputum drainage in 24 hours and the effect on oxybemoglobin saturation and myocardial oxygen consumption were observed. Results As compared with control group, there were significant difference in observation group as following ： the times and the quantity of sputum drainage in 24 hours, the occurrence of mucosa injury, the effect on oxybemoglobln saturation and myocardial oxygen consumption. There were statistical differences before and after aspiration of sputum in HR, SBP and myocardial oxygen consumption. Those of observation group were better than those of control group. Conclusions The effect of sputum suction by tracheal intubation via nasal approach was better than that of tra- ditional way of sputum suction. It cotdd clean the sputum retention, improve ventilation function, reduce hypoxemia and mucosa injury caused by suction, reduce myocardial oxygen consumption, improve oxybemoglobin saturation.