神经外科气管切开病人吸痰深度的探究

Depth of endotracheal suctioning in patients with tracheotomy in department of neurosurgery

[目的]通过探究不同吸痰深度对神经外科气管切开病人心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO_2)和脑组织血氧饱和度(rSO_2)的影响,为吸痰深度的选择提供依据。[方法]采用交叉对照研究,选取2015年5月—2015年12月入住西南某三级甲等医院神经外科并行气管切开病人38例,所有病人均采用深部和浅部两种吸痰方式,观察吸痰前后病人HR,MAP,SpO_2和rSO_2的变化情况;对比分析深、浅吸痰对病人HR,MAP,SpO_2和rSO_2影响。[结果]深部、浅部吸痰前后病人HR,MAP,SpO_2和rSO_2变化规律类似;吸痰后10 min内深部吸痰、浅部吸痰组HR,MAP,SpO_2和rSO_2差异均无统计学意义(P>0.05);但HR、MAP恢复至吸痰前水平所需时间深部吸痰组更长。[结论]对于神经外科气管切开病人吸痰深度的选择,以浅部吸痰更为安全。

Objective： To investigate the influence of different depth of endotracheal suctioning on neurosurgery tracheotomy patient’s heart rate（HR）,mean arterial pressure（MAP）, pulse oxygen saturation（Sp0 2） and re-gional oxygen saturation（rS02） ,and so as to provide evidences for selections the depth of endotracheal suctio-ning. Methods： A crossover design was performed,and 38 hospitalized patients with tracheotomy were selected in the neurosurgery in a southwest third grade A hospital from May 2015 to December 2015. All the patients were performed both the deep and shallow endotracheal suctioning; compared the changes of HR, MAP, Sp0 2 and rS02 before and after suctioning; analyze the difference of HR,MAP,Sp0 2 and rS0 2 between deep and shallow endotracheal suctioning. Results： The variation principle of the HR,MAP,Sp0 2 and rS0 2 before and after endo-tracheal suctioning on were similar; the HR,MAP,Sp0 2 and rS0 2 between deep and shallow endotracheal suc-tioning had no statistical difference after suctioning in 10 minutes;the deep endotracheal suctioning need a lon-ger time to return to baseline. Conclusions： Shallow endotracheal suctioning seemed to be safer for patients in de-partment of neurosurgery.