密闭式吸痰法对机械通气患儿炎性指标及气道损伤的影响

Effect of Closed Sputum Suction on Inflammatory Index and Airway Injury in Children with Mechanical Ventilation

目的:探讨密闭式吸痰法对机械通气患儿气道压力及血气指标的影响。方法:选取2017年1月-2019年12月于笔者所在医院接受机械通气治疗的100例患儿,依据盲抽法分为对照组(n=48)与观察组(n=52)。两组均予以常规治疗,在此基础上,对照组予以开放式吸痰法,观察组予以密闭式吸痰法,比较两组患儿气道压力、血气指标、炎性指标、气道损伤率及病死率。结果:吸痰后,两组气道压力均较吸痰前低,且观察组较对照组低,差异有统计学意义(P<0.05);吸痰后,两组SaO2、PaO2水平均较吸痰前高,PaCO2水平较吸痰前低,且观察组上述指标均优于对照组,差异有统计学意义(P<0.05);治疗后,两组CRP、TNF-α、IL-6水平均较治疗前低,且观察组较对照组低,差异有统计学意义(P<0.05);与对照组气道损伤率(18.75%)相比,观察组(3.85%)低,差异有统计学意义(P<0.05);与对照组病死率(4.17%)相比,观察组(1.92%)略低,差异无统计学意义(P>0.05)。结论:机械通气患儿采用密闭式吸痰法效果显著,可有效降低患儿气道压力,改善血气指标与炎性指标,同时降低病死率。

Objective:To investigate the effect of closed sputum suction on airway pressure and blood gas index in children with mechanical ventilation.Method:A total of 100 children who received mechanical ventilation in our hospital from January 2017 to December 2019 were divided into control group(n=48)and observation group(n=52)according to blind extraction.The two groups were treated routinely.On this basis,the control group was treated with open sputum suction,and the observation group was treated with closed sputum suction to compare the airway pressure,blood gas index,inflammatory index,airway injury rate and fatality rate of the two groups.Result:The airway pressure of the two groups was lower than that before sputum aspiration,and the observation group was lower(P<0.05).The levels of SaO2 and PaO2 in the two groups were higher than those before sputum aspiration,the levels of PaCO2 were lower than those before sputum aspiration,and the above indexes in the observation group were better than those in the control group(P<0.05).After treatment,the levels of CRP,TNF-αand IL-6 in the two groups were lower than those before treatment,and those were lower in the observation group(P<0.05).Compared with the control group,the gas channel injury rate of 18.75%was lower than 3.85%of the observation group(P<0.05).The fatality rate of observation group 1.92%was slightly lower than 4.17%of control group,but the difference was not statistically significant(P>0.05).Conclusion:The method of closed sputum suction can effectively reduce airway pressure,improve blood gas index and inflammatory index,and reduce mortality.