三通管密闭式吸痰在急性呼吸窘迫综合征患者机械通气中应用的安全性

The security discussion of closed endotracheal suction in adult acute respiratory distress syndrome patient received mechanical ventilation

目的:探讨急性呼吸窘迫综合征(ARDS)患者机械通气吸痰方法的安全性。方法:将40例建立人工气道行机械通气的ARDS患者随机分为观察组和对照组,各20例,对照组应用常规开放式吸痰法(即脱机吸痰),观察组使用三通管不脱机密闭式吸痰。对2组患者吸痰前后动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、心率(HR)、收缩压(SBP)、舒张压(DBP)的变化进行监测。结果:对照组吸痰后PaO2、SaO2较吸痰前均明显降低,HR、SBP均明显升高(P<0.01),DBP变化差异均无统计学意义(P>0.05);观察组吸痰后PaO2、SaO2、DBP较吸痰前变化差异无统计学意义(P>0.05),HR、SBP均明显降低(P<0.01);2组吸痰前后PaO2、SaO2变化的差异均有统计学意义(P<0.01)。结论:应用三通管不脱机密闭式吸痰能降低ARDS机械通气患者由吸痰引起的低血氧水平,维持血流动力学稳定。

Objective:To explore the safety suction method for adult acute respiratory distress syndrome(ARDS) patients who received mechanical ventilation.Methods:Forty ARDS patients who received mechanical ventilation by implementation of artifical airway were randomly divided into experimental and control groups,20 cases in each group.The patients in experimental group were performed with closed endotracheal suction by the tee tubes without offline and the patients in control group were performed common open style suction.The variations of partial pressure of oxygen in artery(PaO2),arterial oxygen saturation(SaO2),heart vatel(HR),diastolic blood pressure(DBP) and systolic blood pressure(SBP) were monitored in each group.Results:In control group after endotracheal suction,the levels of SaO2 and PaO2 were decreased,the levels of SBP and HR were increased(P<0.01),and no significant change of DBP(P>0.05).In experimental group after endotracheal suction,there had no significant changes of the levels of SaO2,PaO2 and DBP,HR and SBP were decreased(P>0.05).Compared with control group,the changes of PaO2 and SaO2 had significant differences in experimental group(P<0.01).Conclusions:Closed endotracheal suction by tee tubes without offline can improve blood oxygen levels in ARDS patients who received mechanical ventilation and maintain hemodynamical stablity.