经鼻留置吸痰管用于重症支气管扩张症患者效果评价

Effect of nasal catheter for sputum suction tube on patients with bronchiectasis

目的探讨经鼻留置吸痰管于气管内按需吸痰辅助治疗重症支气管扩张症患者的临床疗效。方法将符合条件的61例患者随机分为对照组30例和观察组31例,对照组按常规给予抗生素、对症支持、雾化吸入、体位引流,观察组在此基础上给予气管内留置吸痰管,通过留置吸痰管向气管内注入气道湿化液,根据需要从留置吸痰管内按需吸痰。以动脉血氧分压、动脉血二氧化碳分压、咳嗽、咳痰、呼吸困难、住院天数、行机械通气例数为观察指标。结果经治疗后,对照组患者入院96 h氧分压(75.1±3.3)mm Hg(1 mm Hg=0.133 k Pa),入院96 h二氧化碳分压(52.4±3.4)mm Hg,入院120 h氧分压(78.6±4.7)mm Hg,入院120 h二氧化碳分压(51.8±3.9)mm Hg;与观察组的入院96 h氧分压[(79.8±5.4)mm Hg]、入院96 h二氧化碳分压[(49.1±2.8)mm Hg]、入院120 h氧分压[(84.9±4.4)mm Hg]、入院120 h二氧化碳分压[(48.3±2.2)mm Hg]比较差异有统计学意义(P<0.01);对照组呼吸困难(2.78±0.47)分,与观察组的(2.43±0.39)分比较,差异有统计学意义(P<0.01);对照组患者住院天数为(21.93±4.87)d,行机械通气5例;观察组患者住院天数(16.55±3.71)d,机械通气0例,两组比较差异有统计学意义(P<0.01或<0.05)。结论重症支气管扩张症患者经鼻留置吸痰管按需吸痰对患者有辅助治疗作用,能及时解除痰液滞留,保持呼吸道通畅,改善患者的缺氧状态,缩短病程。

Objective To investigate the effect of indwelling sputum suction tude on patients with bronchiectasis.Methods A total of 61 patients were divided into observation group（ n = 30） and control group（ n = 31）,the patients in control group received antibiotics,symptomatic support,atomization inhalation and posture drainage,and the patients in observation group received sputum suction tube through the nose in addition,airway moist and sputum suction as required. The arterial blood oxygen partial pressure,arterial blood CO2 partial pressure,sputum,dyspnea,hospitalization days and mechanical ventilation cases of the two groups were observed. Results After treatment,the oxygen partial pressure of control group was（ 75. 1 ±3. 3） mm Hg（ 1 mm Hg = 0. 133 k Pa） at 96 hours after admission,the CO2 partial pressure was（ 52. 4 ± 3. 4） mm Hg at 96 hours after admission,the oxygen partial pressure of oxygen partial pressure was（ 78. 6 ± 4. 7） mm Hg at 120 hours after admission,the CO2 partial pressure was（ 51. 84 ± 3. 9） mm Hg at 120 hours after admission; the oxygen partial pressure of observation group was（ 79. 8 ± 5. 4） mm Hg at 96 hours after admission,the CO2 partial pressure was（ 49. 1 ± 2. 8） mm Hg at 96 hours after admission,the oxygen partial pressure of oxygen partial pressure was（ 84. 9 ± 4. 4） mm Hg at 120 hours after admission,the CO2 partial pressure was（ 48. 3 ± 2. 2） mm Hg at 120 hours after admission,the differences between the two groups were significant（ P〈0. 01）. The dyspnea score in the control group was 2. 78 ± 0. 47,and that in the observation group was 2. 43 ± 0. 39,the difference between the two groups was significant（ P〈0. 01）. Hospitalization days of the control group was（ 21. 93 ±4. 87） d,5 cases had mechanical ventilation; hospitalization days of the observation group was（ 16. 55 ± 3. 71） d,no mechanical ventilation case,the differences between the two groups were significant（ P〈0. 01,P〈0. 05）. Conclusion Nasal catheter suction tube to sputum aspiration for patients with bronchiectasis can eliminate sputum retention,maintain airway patency,improve hypoxia of patients,shorten the course of disease.