不同强度负压在声门下吸引中的效果比较

Effect Comparison of Different Intensity Negative Pressure in Glottis Suction

目的探讨不同强度负压在声门下吸引中的效果。方法 2018年1-12月,入住ICU气管切开且行声门下吸引患者80例,按照声门下吸引开始时间顺序随机分为A组及B组,各40例,A组负压为10~15 kpa,B组负压为15~20 kPa,观察比较两组患者声门下吸引时呛咳的频次,心率及血氧饱和度情况,声门下间隙粘膜损伤情况,肺部感染发生例数及每日滞留物吸引总量。结果患者呛咳,心率及血氧饱和度情况,声门下间隙粘膜损伤情况两组差别无统计学意义(P>0.05)。A组肺部感染发生例数较B组多,每日吸引出的滞留物B组较A组多,差异均有统计学意义(P<0.05)。结论采用负压15~20 kpa行声门下吸引,对患者气道刺激小,少呛咳;声门下间隙粘膜损伤小;对患者心率及血氧饱和度变化无影响;同时可以有效吸尽声门下滞留物,降低肺部感染发生率,是安全且有效的负压范围,提高了人工气道的管理水平,减轻患者的痛苦及医疗资源的浪费。

Objective To investigate the effect of different intensity negative pressure on subglottic aspiration. Methods From January 2018 to December 2018, stay in ICU patients with tracheotomy and line subglottic attract 80, according to the subglottic attract start time sequence were randomly divided into group A and group B, each 40, negative pressure for10 to 15 kPa group A, group B negative pressure for 15 to 20 kPa, comparetwo groups of patients when be being attracted subglottic choking cough frequency, heart rate and blood oxygen saturation, subglottic clearance mucosal damage, pulmonary infection cases and total daily retentate attract. Results There was no significant difference in cough, heart rate, blood oxygen saturation and subglottic mucosal injury between the two groups(P>0.05). The incidence of pulmonary infection in group A was more than that in group B, and the daily excretion of residues in group B was more than that in group A, with statistically significant differences(P<0.05). Conclusion Subglottic suction with negative pressure of 15~20 kpa can stimulate the airway less and reduce cough. The subglottic interstitial mucosa injury was small. The changes of heart rate and blood oxygen saturation were not affected. At the same time, it can effectively absorb the subglottic retention, reduce the incidence of pulmonary infection, is a safe and effective negative pressure range, improve the management level of artificial airway, reduce the pain of patients and waste of medical resources.