密闭式气管内吸痰对急性呼吸窘迫综合征患者气体交换的影响

Effects of Closed Endotracheal Suction on Patients with Acute Respiratory Distress Syndrome

目的研究更适合急性呼吸窘迫综合征(ARDS)机械通气患者气管内吸痰的方式。方法选取外科重症监护病房(SICU)诊断为ARDS并行机械通气治疗的患者为研究对象,每一研究对象随机选择使用开放式气管内吸痰(OS)和密闭式气管内吸痰(CS)两种吸痰方式,于吸痰前后抽血进行血气分析,并记录脉搏血氧饱和度(SpO2)的变化。结果OS后患者动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、SpO2与吸痰前比较均显著降低(P<0.05);CS前后比较上述指标差异无统计学意义(P>0.05)。结论OS可加重患者低氧血症;对ARDS患者吸痰时选择CS方式更适宜和安全。

Objective To find a better way of endotracheal suction and care in acute respiratory distress syndrome(ARDS) patients on mechanical ventilation. Methods 14 ARDS patients who were on mechanical ventilation in SICU were enrolled. Both open endotracheal suction (OS) and closed endotracheal suction ( CS) techniques were performed on each patient in randomized order. The data of blood gas and oxygen saturation by pulse oximetry (SpO2) were obtained before and after suction. Results There was a significant decrease in PaO2,SaO2 and SpO2 after OS ( P <0.05). The differences were not statistically significant before and after CS. Conclusion The results of the study show that OS may aggravate hypox emia in ARDS patients, and CS technique is comparatively safer and more comfortable for ARDS patients.