预置吸痰管持续性低负压吸引对麻醉恢复室患者麻醉复苏质量的影响

The effect of continuous low vacuum suction with preseted suction tube on the quality of anesthesia resuscitation for patients in anesthesia recovery room

目的探讨预置吸痰管持续性低负压吸引对麻醉恢复室患者麻醉复苏质量的影响。方法选取气管插管全麻患者114例,随机分为常规组(C组)、后吸组(S组)和预置组(P组),每组48例。C组常规拔管时清理分泌物,S组拔管后再清理分泌物,P组预置吸痰管持续低负压吸引分泌物。记录各组患者进入PACU时(T1)、拔管期间(T2)、拔管后5 min(T3)、出PACU时(T4)各时间点的MAP、SpO_(2)及HR;记录恶心呕吐、躁动发生、口腔黏膜损伤情况、患者PACU复苏时间。结果T2、T3时间点P组MAP、SpO_(2)及HR均优于C组或S组,差异有统计学意义(P<0.05),T2时间点S组MAP低于C组,差异有统计学意义(P<0.05);P组恶心呕吐、躁动发生、口腔黏膜损伤均少于S组,差异有统计学意义(P<0.05),S组躁动发生率高于C组,差异有统计学意义(P<0.05)。结论气管插管全麻中预置吸痰管持续低负压吸引清理口腔分泌物降低拔管期间心血管反应,减少吸痰管操作相关并发症,提高麻醉恢复室患者全麻复苏质量。

Objective To explore the effect of continuous low vacuum suction with preseted suction tube on the quality of anesthesia resuscitation for patients in anesthesia recovery room.Methods A total of 144 patients with endotracheal intubation under general anesthesia were randomly divided into routine group(Group C),posterior vacuum suction group(Group S)and the preseted group(Group P).In Group C,the secretions were cleaned during routine extubation.In Group S,the secretions were cleaned after extubation.In Group P,the preset sputum suction tube continued to attract the secretions with low negative pressure.MAP,SpO_(2) and HR at each time point of entering PACU(T1),extubation(T2),5 minutes after extubation(T3)and extubation(T4)in each group were recorded.The occurrence of nausea,vomiting,agitation,oral mucosal injury and PACU resuscitation time were recorded.Results At T2 and T3,MAP,SpO_(2) and HR in Group P were better than those in Group C or Group S,and the differences were statistically significant(P<0.05).The MAP of Group S at T2 was lower than that of Group C,and the difference was statistically significant(P<0.05).The incidence of nausea,vomiting,agitation and oral mucosal injury in Group P was less than that in Group S,and the difference was statistically significant(P<0.05).The incidence of agitation in Group S was higher than that in Group C,and the difference was statistically significant(P<0.05).Conclusions The preseted sputum suction tube in tracheal intubation general anesthesia can be used to continuously clean oral secretions with low negative pressure to reduce cardiovascular reaction during extubation,reduce complications related to sputum suction tube operation,and improve the recovery quality of general anesthesia for patients in anesthesia recovery room.