经鼻咽通气道吸痰与常规方式吸痰的对比观察

Study the difference of suction between nasopharyngeal airways and common ways

目的探讨经鼻咽通气道吸痰的临床疗效、呼吸道粘膜损伤情况及病人耐受性。方法选择ICU病人120例，随机分为经鼻咽通气道吸痰组（鼻咽组）及常规吸痰组（常规组）各60例。常规组采用中央负压吸引，吸痰管常规经口腔、鼻腔吸取呼吸道分泌物；鼻咽组在设置了鼻咽通气道后同样采用中央负压吸引，吸痰管经鼻咽通气道吸取呼吸道分泌物；观察吸痰前及吸痰后20min动脉血二氧化碳分压（PaCO2）、血氧饱和度、吸痰间隔时间、有无粘膜损伤及病人耐受性。结果两组患者吸痰前PaCO2、SaO2比较无显著性差异，P〉0．05，PaCO2吸痰后下降，SaO2升高，与吸痰前比较差异有显著性，P〈0．05；鼻咽组PaCO2下降、SaO2升高程度大于常规组，差异有显著性，P〈0．05；鼻咽组吸痰间隔时间、粘膜损伤发生率及病人不耐受率低于常规组，差异有显著性，P〈0．05。结论经鼻咽通气道吸痰在临床吸痰效果、降低粘膜损伤及病人耐受性等方面均优于常规方式吸痰，而且可以解除上呼吸道阻塞，置入方法简单，具有临床应用价值。

Objective To study the clinical effectiveness, mucous membrane injury and patient tolerance of suction by nasopharyngeal airway. Methods 120 patients in ICU were divided into nasopharyngeal airways and common ways groups. To study arterial blood gas about PaCO2 and SaO2 before and after suction 20 minutes, interval time of suction and incidence rate of mucous membrane injury and patient tolerance through different ways. Results Under two ways, There was no difference of PaCO2 and SaO2 before suction, P 〉 0. 05 ; there was significantly different in decreasing PaCO2 and increasing SaO2 after suction , P 〈 0. 05 ; it was much lower in incidence rate of mucous membrane injury and patient intolerance, longer interval time of suction through nasopharyngeal airway, P 〈 0. 05. Conclusions It is better that through nasopharyngeal airways suction than through common ways in clinical effectiveness, decreasing incidence of mucous membrane injury and patient intolerance. Suction by nasopharyngeal airway can release the obstruction of upper airway and is easy to be done.