不同吸痰方式对急性呼吸衰竭患者呼吸系统顺应性的影响

Different ways of sputum aspiration adaptation effects on the respiratory system in patients with acute respiratory failure

目的观察对比开放式吸痰(OS)和密闭式吸痰(CS)对急性呼吸衰竭患者呼吸系统顺应性的影响。方法将60例机械通气的呼吸衰竭患者随机分为开放组和密闭组各30例,对开放组运用开放式吸痰,对密闭组运用密闭式吸痰,分别对比两组患者吸痰前和吸痰后2min呼吸系统静态顺应性(Cst)、气道峰压(Ppeak)、气道平台压(Pplat)等指标。结果密闭组吸痰前和吸痰后2min患者的Cst、Ppeak、Pplat值均无明显变化,差异无统计学意义(P>0.05)。开放组吸痰前和吸痰后2min患者的Cst、Ppeak值无明显变化差异无统计学意义(P>0.05),但Pplat水平明显升高,和吸痰前比较差异显著,具有统计学意义(P<0.05)。结论开放式吸痰和密闭式吸痰对急性呼吸衰竭患者呼吸系统顺应性均无显著性影响,开放式吸痰会使患者气道平台压力升高。密闭式吸痰能够保持良好的气道压力,可作为呼吸衰竭患者吸痰的首选方法。

Objective To observe and compare the open suction （OS）and closed endotracheal suction （CS）compliance of respiratory system in patients with acute respiratory failure. Methods 60 patients with mechanical ventilation in patients with respiratory failure were randomly divided into open and closed group with 30 eases in each group, the open group using open sucking sputum, confined to the group using closed endotracheal suction, respectively, compared two groups of patients before and after sucking sputum suction of 2rain static compliance （Cst）, gas channel peak pressure （Ppeak）, plateau airv^ay pressure （Pplat） and other indicators. Results The closed grouP before aspiration of sputum and 2min in patients with Cst, P＇peak, Pplat value had no significant change after endotracheal suction, no significant difference （P 〉 0.05）. The open group sputum suction in patients with 2min before and after Cst, Ppeak had no obvious change was not statistically significant （P 〉 0.05）, but the levels of Pplat increased significantly, and there was significant difference before aspiration of sputum, with statistical significance （P 〈 0.05）. Conclusion Open sucking sputum and closed endotracheal suction sex had no significant influence on respiratory compliance, open sucking sputum patients will plateau airway pressure. Closed suction to maintain airway pressure good, can be used as the preferred method of respiratory failure in patients with sputum suction.