密闭式吸痰对急性呼吸窘迫综合征患者肺换气功能的影响及护理干预

Effect and Nursing Intervention of Closed Sputum Suction on Pulmonary Ventilation Function of Patients with Acute Respiratory Distress Syndrome

目的研究密闭式吸痰对急性呼吸窘迫综合征患者肺换气功能的影响,并制定相应的护理干预方案。方法现共选取2019年1月-2020年2月于本院接受治疗的66例急性呼吸窘迫综合征患者作为主要对象,采用数字随机表法将其分为两组,33例/组。对照组采用开放式吸痰,观察组采用密闭式吸痰,比较两种不同吸痰方式对患者肺换气功能的影响和不良反应发生情况。结果吸痰前后观察组患者的氧分压和肺泡—动脉血氧分压差比较无显著差异(P>0.05);对照组患者吸痰后的二氧化碳分压水平和肺泡—动脉血氧分压差均小于吸痰前,经比较有显著差异(P<0.05)。经治疗前两组患者血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))以及呼吸频率比较,差异无统计学意义(P>0.05);治疗后两组患者PaCO_(2)、呼吸频率均降低,PaO_(2)均升高,观察组较PaCO_(2)、呼吸频率、PaO_(2)均优于对照组,差异具备统计学意义(P<0.05)。胃肠胀气、相关性肺炎、切口感染等不良反应发生率比较,观察组显著较低,差异具备统计学意义(P<0.05)。观察组患者的吸痰所用时间明显短于对照组,两组比较存在显著差异(P<0.05)。结论对急性呼吸窘迫综合征患者采用密闭式吸痰模式对患者肺换气功能产生的影响小,安全性高,同时配合针对性的护理干预更有利于提升总体护理工作质量和工作效率,因此具备临床应用和推广价值。

Objective To study effect of closed sputum suction on pulmonary ventilation function of patients with acute respiratory distress syndrome,and formulate corresponding nursing intervention programs.Methods The paper chose 66 patients with acute respiratory distress syndrome treated in our hospital from January 2019 to February 2020 as main subjects,and divided them into two groups by digital random table method,33 cases/group.Control group was treated with open sputum suction,and observation group with closed sputum suction.Effect of two different sputum suction methods on lung ventilation function and incidence of adverse reactions of patients was compared.Results There was no significant difference in oxygen partial pressure and Alveolar arterial oxygen partial pressure between observation group and control group before and after sputum aspiration,(P>0.05).Level of carbon dioxide partial pressure and Alveolar arterial oxygen partial pressure after sputum aspiration in control group was lower than before sputum aspiration,with significant difference after comparison,(P<0.05).Before treatment,there was no significant difference between two groups in blood oxygen partial pressure(PaO_(2)),arterial blood carbon dioxide partial pressure(PaCO_(2))and respiratory rate(P>0.05).After treatment,PaCO_(2)and respiratory rate decreased and PaO_(2)increased in two groups,PaCO_(2),respiratory rate and PaO_(2)of observation group was better than control group,difference was statistically significant(P<0.05).Incidence of gastrointestinal flatulence,associated pneumonia,incision infection and other adverse reactions in observation group were significantly lower,difference was statistically significant(P<0.05).Sputum aspiration time of observation group was significantly shorter than control group,there was significant difference between two groups,(P<0.05).Conclusion Closed sputum suction mode has little impact on pulmonary ventilation function of acute respiratory distress syndrome patients with high safety.At the same time,combined with targeted nursing intervention,it is more conducive tothe improvement of overall quality and efficiency of nursing work,which has clinical application and promotion value.