食管切除病人术后雾化吸入方式改进的临床观察

Improvement of nebulization for patients undergoing esophagectomy

目的：探讨适用于食管切除术后病人更理想的雾化吸入方案,以促进病人有效排痰,预防术后肺部并发症。方法：选择重庆医科大学附属第一医院胸心外科2008年1月-6月行全麻开胸食管切除食管胃弓上吻合病人60例,随机分为2组,实验组采用0.45%氯化钠作为湿化剂持续24h氧气雾化吸入,对照组采用0.9%氯化钠作为湿化剂行氧气雾化吸入4次/d,15min/次,并根据痰液的黏稠度增加雾化吸入次数。结果：两组病人在使用氧气雾化吸入后血气分析结果提示pH、PO2、PCO2值之间差异无统计学意义（P〉0.05）,实验组湿化适中例数多于对照组有统计学差异（P〈0.01）,湿化不足例数小于对照组有统计学差异（P〈0.01）,湿化过度例数无统计学差异（P〉0.05）。结论：食管切除术后病人采用0.45%氯化钠早期、持续氧气雾化吸入不仅降低痰液的黏弹性,还可维持血中氧分压的稳定。

Objective：To explore the optimal way of oxygen nebulization that can effectively induce sputum and prevent post-operative pulmonary complications for patients underwent esophagectomy. Methods： 24h Continuous oxygen nebulization（0.45% sodium chloride as regular automized liquid） was administered in 60 patients after esophagectomy in the Department of Cardiothoracic Surgical, the First Affiliated Hospital,Chongqing Medical University. Results： No statistics difference of the blood-gas test were found between the tow groups（P〉0.05）.Among the test group.the number of medium nebulization were significatly more than that in the contrast group（P〈0.01）.while the number of patient lack of nebulization were significatly less than the contrast group（P〈0.01）.And the over nebulization patients were no significate difference between two groups（P〉0.05）.Conclusions： Early continuous and administration of oxygen nebulization with 0.45%sodium chloridecan not only decrease the Visco-elasticity of sputum, but aslo sustain the stability of oxygen partial pressure in blood in the study.