气管切开术后不同给氧方式对患者血气影响的临床研究

The clinical study about the effect of different oxygen in-hale way to post tracheotomy patients' blood gas analysis

目的 探讨气管切开术后不同给氧方式对重型颅脑损伤患者血气的影响 ,以选择最佳的气管切开给氧方式 ,提高氧疗的效果。方法 选择重型颅脑损伤患者 2 5例 ,采取自身对照的方式 ,于气管切开后给氧。在气管套管口覆盖双层盐水湿纱布 ,6h后测定血气分析变化 ,然后改用自制气管切开罩给氧 6h ,再次测定其血气分析的变化。结果 2组比较显示其血气分析 ,在酸碱代谢平衡 (χ2 值 =7.778,P值 =0 .0 2 0 )、氧分压 (t值 =- 5 .6 5 1,P值 =0 .0 0 0 )及碱剩余 (t值 =-3.4 0 8,P值 =0 .0 0 3)方面差异有非常显著性 ,同时在二氧化碳分压 (t值 =- 2 .5 84 ,P值 =0 .0 17)方面差异亦有显著性。结论 气管切开后 ,气管切开罩能有效改善肺的通气功能 ,提高氧含量 ,维持机体酸碱平衡 ,预防和治疗呼吸性碱中毒和呼碱代酸中毒 ,减少电解质紊乱的发生。

Objective To investigate the effect of different oxygen inhale way to the blood and breath of severe cranial disease patients after tracheotomy surgery, so as to select the best oxygen inhale way of tracheotomy and increase the effect of oxygen therapy.Methods25 case severe cranial disease was selected to inhale oxygen after tracheotomy according to self-contrast way.First, put double saline wet gauze at the entrance of trachea tube for 6 hours and measure the changing of the blood gas analysis. Then inhale oxygen by self-made tracheotomy cover for another 6 hours and measure the changing of blood gas again.ResultsThere are significant difference bewteen 2 groups by comparing blood gas analysis in acid-bas metabolic balance,PO 2, BE, at same time in PCO 2.ConclusionUsing oxygen cover can improve the ventilate function of lung after tracheotomy, enhance oxygen content, maintain body acid-base balance, prevent and treat respiratory alkalosis, respiratory alkalosis and metabolic acidosis, decrease the happening of electrolytic disorder.