颈脊髓损伤患者人工气道吸痰导管插入深度探讨

Discussion of intubating depth of sucker tube through artificial air passage for patient with cervical and spinal cord injury

目的:探讨颈脊髓损伤患者行人工气道吸痰时吸痰管插入的有效深度.方法:将48例颈脊髓损伤并行气管切开患者随机分为A、B、C三组各16例,A组深吸痰,即吸痰导管插入深度为遇到阻力后上提0.5～1cm;B组浅吸痰,即吸痰导管插入深度为小于气管插管或气管切开套管的长度;C组吸痰导管插入深度为气管插管或气管切开套管的长度再延长1cm.观察3种方法吸痰的效果.结果:A、B两组患者刺激性咳嗽、血氧饱和度下降、黏膜损伤出血、痰痂堵塞及肺部感染发生率与C组比较有显著性差异(P<0.05,P<0.01),C组效果好于A、B两组.结论:颈脊髓损伤患者行人工气道吸痰时,吸痰管插入深度以气管插管或气管切开套管长度再延长1cm为宜.

Objective:To study the effective intubating depth of sucker tube through artificial air passage for patient with cervical and spinal cord injury.Methods:Forty eight patients who received tracheotomy due to cervical and spinal cord injury were divided into A,B,C group(16 cases for each) at random.Deep intubation was taken in sputum aspiration in group A,that is the sucker tube was withdrawn 0.5-1 cm when you felt any resistance;in group B,shallow intubation was used,that meant the depth of sucker tube was less than the length of sucker tube or cannula;in group C,the intubating depth was 1 cm longer than the length of sucker tube and cannula.The effect of the 3 kinds of sputum aspiration was observed.Results:There was significant difference in the comparison of the incidence of irritative cough,degression of arterial oxygen saturation,mucosal bleeding,phlegm blocking and lung infection among the three groups(P<0.05,P<0.01).The outcome of group C was much better among the groups.Conclusion:The optimal intubating depth is 1 cm longer than the length of sucker tube and cannula when intubation is applied through artificial air passage for patient with cervical and spinal cord injury.