非人工气道昏迷患者多种吸痰方式的效果观察

The clinical effect of different modes of sputum suction in the stupor patients with non artificial airway

目的探讨非人工气道下昏迷患者多种吸痰方式的效果观察，为优化临床吸痰方式提供依据。方法选取武警总医院急诊监护室2012年10月～2014年9月收治的219例非人工气道下昏迷患者随机分成A、B、C三组。A组68例：患者出现痰鸣音采用按需吸痰。B组72例：患者出现痰鸣音采用叩背l^5min后吸痰。C组79例：患者出现痰鸣音后采用边叩背边吸痰方式，对比3组吸痰方式吸痰效果及气道粘膜损伤情况。结果c组吸痰方式达优率为54％，明显高于A组（43％）、B组（46％），C组坠积性肺炎发生率为40．5％，低于A组（58．8％）、B组（58-3％），而c组吸痰方式气道黏膜损伤率为20．25％，低于A组（30．88％）、B组（27．77％），差异均有统计学意义（P〈0．05）。结论边叩背边吸痰，能有效地将痰液排出，增加肺泡通气量，提高患者呼吸道气体交换率，提高血氧，减少患者气道损伤。

Objective To observe the clinical effect of different modes of sputum suction in the stupor patients with non artificial airway, we started our study. Methods 219 stupor patients ,received in our emergency care unit on October 2012 to September 2014,were divided into three groups .In A group （n=68）,the stupor patients with wheezy phlegm were treated with demand based sputum suction.In B group （n=72）, the stupor patients with wheezy phlegm were treated with percussion on back, and treated with sputum suction, l-5 minutes later In C group （n=79）,the sputum patients with wheezy phlegm were treat with percussion on back when sputum suction.The effect of different modes of sputum suction and airway mucosa damage were compared. Results As for the excellent rate of sputum suction ,C group （54%） was higher than A group （43%） and B group （46%）. The incidence of hypostatie pneumonia ,C group （40.5%） was lower than A group （58.8%） and B group（58.3%）.For the damage rate of airway mueosa ,C group （20.25%） was lower than A group （30.88%） and B group（27.77%）. Conclusion Percussion on back with sputum suction can make sputum more effectively , increasing efficiency of alveolar ventilation, increasing rate of gas exchange in respiratory, improving blood oxygen and reducing airway mucosa damage.