两种不同的排痰方法在婴幼儿心内直视术后机械通气患儿中的应用及效果观察

Application and effective observation of two different methods of sputum suction in the infant patients undergoing the mechanical ventilation after open heart surgery

目的探讨膨肺和拍背治疗对婴幼儿心内直视术后机械通气患儿的排痰效果和相关并发症。方法选择心内直视术后行机械通气时间≥72 h、年龄≤3岁的患儿40例,随机分为A组和B组,A组吸痰时给予膨肺和拍背,B组给予常规直接吸痰,观察患者的心率、血压、血氧饱和度的变化及呼吸机相关性肺炎(VAP)的发生率等。结果两组患儿吸痰时舒张压之间差异无统计学意义,A组比B组心率显著减慢、收缩压降低,而血氧饱和度显著升高,A组比B组吸痰较彻底,VAP的发生率较低。结论膨肺和拍背治疗吸痰法优于常规直接吸痰法,应将其作为常规治疗。

Objective To investigate the effect of sputum suction and related complications of lung inflation and clapping back in infant patients undergoing mechanical ventilation after open heart surgery. Methods Forty mechanical ventilation infant patients after the intraeardiac operations were selected. They must be meet the conditions： the mechanical ventilation time 972 h and age 43 y. And then they were randomly divided into group A and B. Group A received the lung inflation and clapping back for sputum suction. Group B received sputum suction normally. The state of the oxygen saturation, heart rate, and blood pressure, and the occurring rate of the ventilator associated pneumonia（ VAP） in two groups were observed to study how to cure the patients. Results There is no statistical significant differences in the diastolic pressure during the sputum suction between the two groups. Compared with Group B,in Group A, sputum suction was more thoroughgoing ;the occurring rate of the VAP was obviously lower. Compared with Group A, in Group B, inerease of heart rate, rising of systolic pressure and oxygen saturation drop were more eommom. Conclusion When give the mechanical ventilation infant patients sputum suction normally, it will bring on some disadvantage influences, such as tachycardia, rising of systolic pressure, no thoroughgoing sputum suction, rising of occurring rate of the VAP. So, For the mechanical ventilation infant patients, the best cure is to use the lung inflation and clapping back normally for sputum suction.