不同吸痰方式对有创呼吸机治疗肺不张患者呼吸循环功能的影响

Effect of Different Sputum Suction Methods on Respiratory and Circulatory Function of Patients with Atelectasis Treated by Invasive Ventilator

目的探讨开放式与闭合式吸痰方式对有创呼吸机治疗肺不张患者呼吸循环功能的影响。方法选择2017年3月至2019年2月本院收治的应用有创呼吸机出现肺不张者80例,按照随机数字表法分为两组,各40例。对照组采用开放式吸痰方法,观察组实施密闭式吸痰干预,比较干预过程中(干预前、干预后15 min、干预后30 min)两组氧合指数变化,比较两组干预过程中循环相关指标变化情况,调节两组干预过程中出现的并发症,如气胸、肺出血、呼吸抑制、低氧血症发生情况。结果干预后15 min及干预后30 min,观察组氧合指数均显著高于对照组(P<0.05),观察组心率、收缩压及舒张压、均显著低于对照组(P<0.05),观察组出现气胸、肺出血、呼吸抑制、低氧血症总比例显著低于对照组(P<0.05)。结论针对有创呼吸机后出现肺不张患者,应用闭合式吸痰法能有效的维持患者呼吸循环功能稳定,治疗并发症少,安全性高。

Objective To explore the effect of open and closed sputum suction on respiratory and circulatory function of patients with atelectasis treated by invasive ventilator.Methods From March 2017 to February 2019,80 patients with atelectasis caused by invasive ventilator in our hospital were selected and randomly divided into two groups,with 40 cases in each group.The control group were adopted the open sputum aspiration method,while the observation group were implemented the closed sputum aspiration intervention.The changes of oxygenation index during the intervention(before,15min after and 30min after the intervention)were compared between the two groups.The changes of circulation related indexes during the intervention were compared between the two groups,and the complications occurred during the intervention were adjusted,such as pneumothorax,pulmonary hemorrhage,respiratory depression and hypoxemia.Results The oxygenation index of the observation group was significantly higher than that of the control group(P<0.05),the heart rate,systolic pressure and diastolic pressure of the observation group was lower than that of the control group(P<0.05),at 15 min and 30 min after the intervention.During the treatment,the total proportion of pneumothorax,pulmonary hemorrhage,respiratory depression and hypoxemia in the observation group was significantly lower than that of the control group(P<0.05).Conclusion For patients with atelectasis after invasive ventilator,closed sputum suction can effectively maintain stable respiratory and circulatory function of patients,with fewer complications and high safety.