气管内留置吸痰管对重症肺炎患者血氧饱和度及并发症的影响

Effects of tracheal indwelling pipette on blood oxygen saturation and complications in patients with severe pneumonia

目的 探讨气管内留置吸痰管对重症肺炎患者血氧饱和度及并发症的影响.方法 选取2014年12月至2016年12月济南市中心医院收治的重症肺炎患者68例为研究对象,采用随机数字表法将其分为观察组34例和对照组34例,两组患者均给予常规化痰、抗感染等对症治疗,观察组患者在常规治疗基础上给予经鼻腔插入留置吸痰管按需吸痰,对照组患者则在常规治疗的同时根据患者病情随时经口或鼻插入吸痰管吸痰.比较两组患者吸痰前后的血氧饱和度,统计并发症发生情况.结果 吸痰前,观察组患者的血氧饱和度（SpO2）为（89.5±1.4）％ 、呼吸频率（RR）为（31.1±1.5）次/min,对照组分别为（89.7±1.5）％ 、（31.2±1.4）次/min,两组差异无统计学意义（t=0.568,P=0.572;t=0.284,P=0.777）;吸痰后,观察组SpO2（98.4±1.3）％,明显升高,RR显著降低,为（19.8±2.7％）次/min;与吸痰前比较差异均有统计学意义（t=27.163,P=0.000;t=21.333,P=0.000）;吸痰后观察组的SpO2（98.4±1.3）％,明显高于对照组的（90.2±2.6）％,组间差异有统计学意义（t=16.448,P=0.000）;观察组并发症总发生率和病死率分别为26.5％ 和11.8％,对照组分别为67.6％ 和52.9％,观察组并发症发生率和病死率均明显低于对照组（χ2=11.57,P=0.000;χ2=13.17,P=0.000）.结论 经鼻气管内留置吸痰管可显著提高患者的血氧饱和度,减少严重并发症发生概率,对提高救治效果有积极意义.

Objective To investigate the effect of tracheal indwelling pipette on blood oxygen saturation and complications in patients with severe pneumonia. Methods From December 2014 to December 2016,68 patients with severe pneumonia in Ji＇nan Central Hospital were selected and divided into the observation group and the control group according to the random number table method,with 34 cases in each group. The two groups were given conventional phlegm,anti - infection and other symptomatic treatment. The observation group received suction tube through nasal insertion on the need for suction based on the conventional treatment. The control group received mouth or nasal suction according to the patients ＇ condition at any time based on the conventional treatment. The blood oxygen saturation before and after sputum aspiration were compared in the two groups,the incidence of complications were recorded. Results Before sputum suction,the SpO2 ,RR in the observation group were （89. 5 ± 1. 4）％ ,（31. 1 ± 1. 5）times/ min,respectively,which in the control group were （89. 7 ± 1. 5）％ and （31. 2 ± 1. 4）times/ min,respec-tively,there were no statistically significant differences between the two groups （t = 0. 568,P = 0. 572,t = 0. 284,P =0. 777）. After sputum suction,SpO2 was significantly increased in the observation group [（98. 4 ± 1. 3）％ ],RR was significantly lower than that before suction[（19. 8 ± 2. 7） times/ min],the differences were statistically significant between the two groups（t = 27. 163,P = 0. 000;t = 21. 333,P = 0. 000）. The SpO2 in the observation group[（98. 4 ± 1. 3）％ ] was significantly higher than （90. 2 ± 2. 6）％ in the control group （t = 16. 448,P = 0. 000）. The overall incidence rate of the complications and mortality in the observation group were 26. 5％ and 11. 8％ ,respectively, which were significantly lower than 67. 6％ and 52. 9％ in the control group （χ2 = 11. 57,P = 0. 000;χ2 = 13. 17, P = 0. 000）. Conclusion Intravascular retention of suction tube can significantly improve the patients＇ blood oxygen saturation,reduce the risk of serious complications,and has a positive significance to improve the treatment effect.