减少机械通气患者气管内吸引并发症的临床研究

Clinical study on reducing intratracheal suction complications of mechanical Ventilation patients

目的探讨减少机械通气患者气管内吸引合并症的有效护理方法，以提高气道护理质量。方法将80例人工气道机械通气患者随机分为观察组和对照组各40例。对照组常规气道内注入0．9％氯化钠注射液稀释痰液后，定时吸引；观察组在对照组的基础上改进：按需吸痰，选择合适的吸痰管，控制吸痰管插入的深度，随吸痰管插入深度调节负压，吸引前后予以纯氧吸入2～3min，加强气道湿化，吸引管用金霉素眼膏润滑等。比较两组气管内吸引合并症的发生率。结果观察组与对照组所产生的合并症在痰液阻塞、吸引时血氧饱和度（SpO2）下降至80％以下、气道黏膜受损出血方面差异有显著性（P〈0．01）。结论实施改进后的气管内吸引能明显减少痰液阻塞、吸引时SpO2下降至80％以下、气道黏膜受损出血等合并症的发生。

Objective To investigate the effective nursing measures of reducing the complications of intratracheal suction about mechanical ventilation patients to improve airway nursing quality. Methods 80 patients with artificial air passage mechanical ventilation were divided into Control group （ Group one, 40 cases） and Testing group （ Group two, 40 cases ） randomly. In the control group, suck at regular time after injecting normal saline solution into the in-airway （in order to diluted the sputum）. There are improvement that nursing measures in testing group. For eample, suck sputums according to demands, choose appropriate sucking sputums tube, control the deepth of sucking sputum tube, adjust the negative pressure based on the deepth of sucking sputum tube, give pure oxygen two to three minutes before and after the suction, strengthen the airway h umidfication, lubricate the sucking sputum tube with chlorotetracyeline eye ointment, etc. Complications of intratracheal suction were compared in two groups. Results The comparison showed that the complications have a significant statistical difference in sputum obstruction, SpO2 descending to 80 percent and below during suction and airway mucous membrane traumatic hemorrhage. （ P 〈 0. 01 ）. Conclusion The improved intratracheal suction will decrease the complications obviously like sputum obstruction, SpO2 reducing to 80 percent and below during suction and airway mucous membrane traumatic hemorrhage.