吸痰负压对ARDS患者肺容积及肺顺应性的影响

Effect of Different Negative Pressure of Sputum Aspiration on the Lung Recruited Volume and Pulmonary Dynamic Compliance in Patients with Acute Respiratory Distress Syndrome

为分析不同吸痰负压对ARDS患者肺复张容积及动态顺应性方面的影响。前瞻性自身对照分析ARDS患者28例,分别使用150mmHg～200mmHg的负压进行开放式吸痰,记录不同负压吸痰前后肺容积及肺动态顺应性的变化。结果不同吸痰负压下的肺复张容积之间有统计学差异(P<0.05);不同吸痰负压下的肺动态顺应性之间差别无统计学意义(P>0.05);肺动态顺应性与吸痰负压、肺复张容积的回归方程是:Y(肺动态顺应性)=30.702+0.015X1(肺复张容积)+0.005X2(吸痰负压),自变量对X1,X2对肺动态顺应性影响的P值分别为0.630和0.832。因此,在患者允许的情况下,应尽量减少吸痰次数,吸痰时应首选小负压进行吸痰。

To evaluate the different negative pressure of sputum aspiration effect on the lung recruited volume and pulmona- ry dynamic compliance in patients with acute respiratory distress syndrome. In prospective and self-controlled study, twen- ty- eight patients fulfilling criteria for acute respiratory distress syndrome were eligible. They were randomly assigned to be endotracheal suctioning with pressure 150mmHg--200mmHg, then standard procedure endotracheal s uctioning. Record the lung recruited volume and pulmonary dynamic compliance before and after different negative sputum aspiration. The different sputum suctioning negative pressure at the lung recruited volume have statistical significance （P^0.05）. The dif ferent sputum suctioning negative pressure at the pulmonary dynamic compliance have no statistical significance （ P〉 0.05）. The regression relationship between the three indicators is Y（ pulmonary dynamic compliance）= 30. 702 ＋0. 015X1 （lung recruited volume）＋0. O05X2（different negative pressure of sputum aspiration）. The independent variables of X1, X2 on pulmonary dynamic compliance of p values were 0. 630 and 0. 832. Therefore, small negative pressure should be better on the same condition.