目的 探讨新型吸痰法在多发伤并机械通气患者的临床应用价值.方法 选取2014年1月-2015年9月上海市嘉定区中心医院ICU机械通气的多发伤患者60例,采用随机数字表法,将其分为实验组(给予新型吸痰法)和对照组(给予传统吸痰法),每组30例.比较两组患者吸痰前后吸痰效果及并发症发生的次数.结果 与吸痰前相比,吸痰后对照组的SpO2、心率、呼吸频率及实验组的SpO2、呼吸频率差异有统计学意义(P<0.05),但实验组的心率差异无统计学意义(P>0.05).两组吸痰前后的SpO2、心率、呼吸频率相比,均无显著性差异(P>0.05)使用呼吸机期间,两组患者吸痰次数及常见吸痰并发症相比,差异有统计学意义(P<0.05),但死亡率差异无统计学意义(P>0.05).结论 对于机械通气的多发伤患者,相对于传统吸痰法,新型吸痰法能达到同样的吸痰效果,且吸痰相关并发症的发生率明显降低,并能减少住院期间的吸痰次数.
Objective To explore the clinical value of the new aspiration method in patients with multiple injuries and mechanical ventilation. Methods Totally 60 multiple injuries patients with mechanical ventilation were divided into experimental group(n=30, new aspiration method group) and control group(n=30,traditional aspiration method group) randomly. The effect in extraction of sputum and the complications were compared. Results The clinical baseline of the patients were in the same in two groups.Two methods can significantly improve SPO2and reduce the respiratory rate after suctioning(all P<0.05).Compared with the control group,the average number of extraction of sputum was significantly reduced (128.3 ± 72.1 vs 186.8 ± 100.2, P=0.012) in the experimental group. Meanwhile, the average number of complications occurred significantly decreased, such as hypoxemia (43.8 ± 28.2 vs 63.5 ± 35.3,P=0.020), respiratory mucosal injury (73.5 ± 39.4 vs 98.6 ± 53.1,P=0.042), arrhythmia (1.6 ± 1.1 vs 2.4 ± 1.2,P=0.015), airway spasm(33.6±24.1 vs 60.0±32.4,P=0.001).The new method had no effect on mortality(40% vs 46.7%,P=0.602). Conclusions In multiple injuries patients with mechanical ventilation,compared with the traditional method,the new aspiration method can achieve the same effect. The incidence of suction related complications and the number of suction during hospitalization were significantly reduced by using the new method.