定时膨肺吸痰对心脏直视术后机械通气患者肺不张的影响

摘要

Objective:To observe the effects of timing manual lung hyperinflation and suction on the atelectasis in mechanically ventilated patients under-going open-heart surgery.Methods:107 mechanically ventilated patients undergoing open-heart surgery were randomly assigned to experimental group(n=47) and control group(n=60).The patients in experimental group were treated with manual lung hyperinflation and suction once every 8 hours,those in control group,with conventional suction.Changes of the indicators were compared 30 min after the suction concerning PaO2 ,PaCO2 and SaO2 in the two groups,who received chest radiography or lung CT examination after one week of treatment for comparison of the incidence of atelectasis .Results:The pa-tients in the experimental group had significant improvement in hyoxemia and lower incidence of atelectasis after suctioning(P<0.05).Conclusion:Tim-ing manual lung hyperinflation and suction can improve the hyoxemia and reduce the incidence of atelectasis in mechanically ventilated patients undergoing open-heart surgery,suggesting that this management is worthy of wider clinical recommendation .%目的：初步探讨定时膨肺吸痰法对心脏直视手术后机械通气患者肺不张的影响。方法：将107例心脏直视手术后行呼吸机机械通气患者随机分为定时膨肺吸痰组（47例）和常规吸痰组（60例），定时膨肺吸痰组每8 h内用膨肺吸痰法吸痰1次，其余时间按常规吸痰法操作。比较两组患者吸痰后30 min PaO2、PaCO2、SaO2等血气指标的变化；治疗后1周常规行胸片或肺部CT检查，观察比较两组肺不张的发生率。结果：定时膨肺吸痰组患者吸痰后低氧血症较常规吸痰组明显改善（ P＜0．05），肺不张发生率显著低于常规吸痰组（P＜0．05）。结论：定时膨肺吸痰能改善心脏直视术后机械通气患者的低氧血症，减少肺不张的发生率，值得临床推广。