ARDS病人吸痰前后不同氧供方法对SpO_2的影响

Effect of Different Oxygen Supply Methods before and after Sputum Aspiration on SpO_2 in ARDS Patients

目的探讨急性呼吸窘迫综合征 (ARDS)病人吸痰前后不同氧供方法对经皮血氧饱和度 (SpO2 )的影响。方法将提高吸入氧浓度法 (A法 )、过度通气法 (B法 )、单次控制性肺膨胀与提高吸氧浓度结合法 (C法 )及常规法用于 8例ARDS病人吸痰前后 ,并对增加氧供前后的SpO2 、吸痰后SpO2 恢复时间及达稳定时间进行对比 ,各方法每例每天取值 1次 ,各法每例均取值 7次。结果①常规吸痰后SpO2 下降 0 15～ 0 2 5 (平均 0 19) ,5～ 15min(平均9 98min)方可恢复。②与各自对应的基础值比较 ,三种不同氧供法均能使吸痰前、后的SpO2 显著提高 (P <0 0 1、P <0 0 0 1) ,其中C法优于A、B法 ,差异有显著性意义 (均P <0 0 5 ) ,A法与B法比较 ,差异无显著性意义 (P >0 0 5 ) ;而其吸痰后SpO2 下降幅度及恢复时间均明显低于常规法 ,差异有极显著性意义 (均P <0 0 0 1)。③与各自吸痰前基础值相比 ,C法吸痰后SpO2 稳定值显著提高 (P <0 0 0 1) ,而A法、B法及常规法无明显变化 (P >0 0 5 )。结论常规吸痰可致低氧血症发生 ,而A、B、C三种氧供法均能有效预防ARDS病人吸痰所致的低氧血症 ,其中C法效果最佳 。

Objective To explore the effect of different oxygen supply methods before and after sputum aspiration on SpO 2 in ARDS patients .Methods Increasing the inspired oxygen concentration (method A), overventilation (method B), combination of single controlled lung expansion with method A (method C) and routine method, were given to 8 ARDS patients before and after sputum aspiration. The SpO 2 before and after the increase of oxygen supply, SpO 2 recovery time and stable time after sputum were compared. One value was obtained once every day each method for 7 times in each case.Results After routine sputum, SpO 2 was decreased by 0 15～0 25 (mean 0 19) and restored after 5～15 min (mean 9 98 min). As compared with each basal value, all three methods (A, B and C) could obviously increase SpO 2 before and after sputum aspiration (P<0 01, P<0 001 ). The method C was superior to methods A and B (both P <0 05). The decreased amplitude of SpO 2 after sputum aspiration and the recovered time in the methods A, B and C were less than in routine method (all P <0 001). As compared with each basal value before sputum aspiration, SpO 2 stable value after sputum aspiration in the method C was significantly increased ( P <0 001), while no obvious change was found in method A, method B and routine method ( P >0 05).Conclusion Routine oxygen aspiration could induce hypoxia. The above mentioned oxygen supply methods all could effectively prevent the ARDS patients from hypoxia induced by sputum aspiration. The effectiveness of method C was the best, followed by methods A and B.