开放式吸痰方式与密闭式吸痰方式对重型颅脑损伤患者颅内压水平的影响

摘要

目的：探讨开放式吸痰方式（OS）及密闭式吸痰方式（CS）对重型颅脑损伤患者颅内压水平的影响。方法我科2010年1月～2012年12月收治重型颅脑损伤患者84例，所有患者分为两组，分别采用开放式和密闭式两种吸痰方式，在吸痰前及吸痰后分别监测并记录患者的颅内压，对两种吸痰方式的优缺点及效果进行对比分析。结果两种吸痰方式效果评价表明，CS组患者的痰鸣音完全消失及痰鸣音明显减少例数均少于OS组，但无明显差异（P>0.05），CS组发生SpO2≤0.85例数显著小于OS组（P＜0.05）。吸痰过程中HR≤100次/min(bpm)时，可认为发生心率迟缓，CS组发生HR≤100次/min例数小于OS组，但无明显差异（P>0.05）。 CS组患者颅内压水平吸痰后较吸痰前升高（0.90±0.30）mmHg，OS组颅内压水平吸痰后较吸痰前升高（1.20±0.15） mmHg，OS影响患者颅内压增高值显著大于CS（P<0.05）。结论 CS效果与OS相差不大，CS对病患的颅内压影响较小，建议推广应用。%Objective To study the influence of the opened suction and closed suction in the intracranial pressure leve of patients with severe craniocerebral injury. Methods There were 84 cases of patients with severe craniocerebral injury in our department from January 2010 to December 2012. The patients were treated with opened suction or closed suc-tion. The intracranial pressure level had been determined during the sputum suction. The effect of two sputum suction were analyzed. Results The patients of CS group with phlegm song completely disappearing and significantly reducing were less than OS (P>0.05).The patients with SpO2≤0.85 for CS group were significantly less than OS group (P<0.05). The patients of CS group with HR≤100bmp were less than OS group (P>0.05).The intracranial pressure of CS group patients had rised(0.90±0.30) mmHg after sputum suction and the patients with OS had rised (1.20±0.15) mmHg. The increasing values of intracranial pressure for patients with OS was significantly higher than CS (P<0.05). Conclusion The phlegm sputum suction effects of the opened suction don't appear to be much different from closed suction.The in-fluence of the closedsuction on intracranial pressure was less than the opened suction. The closed suctionis is worthy of promoting for the future.