减少新生儿气道内吸痰并发症的探讨

A study about decrease the incidence rate of sputum drainage complication among the newborns

目的改进气道吸痰法以减少并发症的发生。方法将NICU气管插管行呼吸机治疗的新生儿肺炎患儿90例随机分为3组,每组30例。对照组:定时吸痰,常规气道内注入生理盐水稀释痰液,气道冲洗或吸痰前后给予气囊加压给氧,吸痰管送入至遇到抵抗或稍退后,再开始边吸引边转动吸痰管边向外撤出;实验组A在对照组的基础上改进:按需吸痰,常规气道内不注入生理盐水,在吸痰前后5min适当调高呼吸机氧浓度(10%～20%);实验组B在实验组A的基础上再改进:边吸引边转动吸痰管向内插,达到预定深度后迅速撤出。结果实验组B较对照组及实验组A在气道黏膜受损出血方面有显著改善(P<0.01)。实验组B与对照组在所产生的并发症在痰阻、吸痰时经皮测血氧饱和度(SPO2)下降至80%以下方面比较差异有显著性(P<0.01)。结论采用适时准确吸痰及必要时气道内注入生理盐水稀释痰液再吸痰,并在插入吸痰管时采用边吸引边转动吸痰管边向气管插管内送,达到所需深度后迅速撤出的吸痰法时能明显减少气道内吸痰时的并发症。

Objective To study the effective methods to decrease the incidence rate of sputum drainage complication anaong the newborns. Methods Divided 90 newborns in the NICU into 3 groups randc^nly. In the control group, the traditional airway nursing method was used. In the experimental group A, the improved airway nursing method which have based on the traditional airway nursing method was used. In the experimental group B, the improved airway nursing method which have based on the method of experimental group A was used. Results The incidence rate of sputum drainage complication in the control group was significant higher than that of in the experimental group A and B. The airway condition in the experimental group A was significant better than that of in the other two group, P〈 0.01. Conclusion The improved airway nursing method can avoid the shortcoming of traditional airway nursing method, and then decreased the incidence rate of sputum drainage complication among the newborns.