人工鼻对高压氧治疗中气管切开患者痰液的影响

Influence of heat and moisture exchanger on sputum of patients with tracheotomy receiving hyperbaric oxygen treatment

目的观察多人氧舱内气管切开患者使用人工鼻吸氧治疗时，患者痰液的变化。方法随机将239例气管切开患者分别使用L型连接管（L组，111例）和L型连接管加人工鼻连接（HEM组，128例）吸氧法在多人氧舱内进行高压氧治疗。观察2组患者治疗第1、10天的痰液性状、吸痰量、吸痰次数的变化，及封／拔管例数。结果HEM组患者第1天治疗时吸痰次数、吸痰地明显较L组多，第1～10天痰液由黏稠黄色浓痰逐渐变为白色稀薄痰，排痰量明显减少（P〈0．01）。封／拔管并的比例在HEM组显著高于L组（P〈0．01）。结论人工鼻对多人氧舱内气管切开患者高压氧治疗时，有助于痰液湿化，肺内积痰的排出。

Objective To observe characters of sputum of patients with tracheotomy by heat and moisture exchanger （HEM） undergoing hyperbaric oxygen therapy （HBOT） in multi-person chamber. Methods In randomly block design, 239 patients were selected and received HBOT using HEM combined with L-shape tube（group HEM, n=128） and by L-shape tube（group L,n=111 ） respectively. The characters and volume of sputum, times of sucking sputum and cases of sealing/extubation of tubes were assessed over first and tenth sessions of HBOT. Results The times of sucking and volume of sputum over first session of HBOT in the group HEM were more than those in group L. The sputum was changing from ropiness over first session to tenuity over tenth session （P 〈 0.01 ）. Cases with sealing/extubation of tubes in group HEM were more than those of group L （P 〈 0.01）. Conclusions It is helpful to humidify and discharge deposited sputum of patients over routine hyperbaric oxygen by HEM. And the cases of sealing/extubation of tubes are also reduced.