不同吸痰负压对重型颅脑损伤患者的效果比较

Effects Comparison of Different Sputum Suction Pressure on Patients with Severe Craniocerebral Injury

探讨3种不同的吸痰负压对重型颅脑损伤患者的影响,以寻找重型颅脑损伤患者最佳的吸痰负压。选取某三甲医院的ICU重症颅脑损伤患者46例,当患者出现吸痰指征时,分别以3种不同吸痰负压(-75 mmHg,-150 mmHg,-300 mmHg)对患者行密闭式吸痰,在吸痰前2 min、吸痰后5 min以及吸痰后10 min时记录患者的氧动力学和血流动力学变化,同时记录患者的吸痰时间间隔和效果。吸痰负压为-150 mmHg和-300 mmHg的吸痰效果和吸痰间隔时间要优于-75 mmHg的吸痰负压(p<0.05),且吸痰负压为-150 mmHg时,吸痰的间隔时间最长(78.3±29.8)min;不同吸痰负压组不同时间点的氧分压,二氧化碳分压、收缩压、舒张压和平均动脉压差异有统计学意义(p<0.01),且当吸痰负压是-150 mmHg时、吸痰后5 min和10 min时氧分压相对于吸痰前有明显的改善(p=0.00),当吸痰负压为-300 mmHg时,吸痰后5 min相较于吸痰前收缩压、舒张压和平均动脉压都明显提高,具有统计学意义(p=0.00)。-150 mmHg的吸痰负压是安全和有效的适合重型颅脑损伤患者的吸痰负压。

In this study, the effects of three different sputum suction pressure on severe craniocerebral injury patients were compared to search for the optimal sputum suction pressure for patients with severe craniocerebral injury. A total of 46 cases of severe craniocerebral injury patient in a grade A class 3 hospital intensive care unit were collected as research object, who were treated with three different sputum suction pressure （-75mmHg, -150 mmHg and -300 mmHg） when they had indications of sputum suction, and the kinetics of oxygenation and hemodynamics were observed 2 min before suction, 5 and 10 min after suction, also the interval time and sputum suction effect of patients were recorded. The results showed that the interval time and sputum suction effect in -150 mmHg and -300 mmHg group were better than that in -75 mmHg group （p〈0.05）, meanwhile, the interval time was the longest in -150 mmHg group （78.3___29.8） min. Besides, the score ofPaO2, PaCO2, SBP, DBP and MAP in the three groups at different time points had statistically significant difference, and the PaO2 score after 5 min and 10 min suction with the pressure of-150 mmHg was higher than before （p〈0.05）. In addition, the SBP, DBP and MAP score after 5 min suction with the pressure of -300 mmHg were higher than before, and the difference was statistically significant （p〈0.05）. In conclusion, the suction pressure of-150 mmHg was safe and effective for patients with severe craniocerebral injury.