密闭式吸痰管不同吸痰深度对机械通气患者吸痰效果的影响

摘要

Objective To explore the efficacious endotracheal suctioning depth for the patients with mechanical ventilation. Methods The 120 patients with lung infection, moderate airway secretion,closed endotracheal suctioning are divided into ABCgroup. There are 40 patients in each group.In A group,the patients take for the shallow suctioning,such as the length of closed suction catheter inserted is less 1 cm than the length of the intubation catheter. In B group,the patients take for the deep suctioning, such as the closed suction catheter is inserted until the resistance is encountered,then pull it back 1 cm. In C group, the length of closed suction catheter inserted is more 1 cm than the length of the intubation catheter The index of the effectiveness and security of endotracheal suctioning is analyzed among three groups. Results The index of the effectiveness of endotracheal suctioning in B and C group is better than that of A group(P<0.05).The index of the security of endotracheal suctioning in A and C group is better than that of B group(P<0.05).Conclusion The standard method of endotracheal suctioning has the better effectivity and safty.It is able to reduce the complications.%　　目的探讨机械通气患者有效、安全的吸痰深度。方法将120例肺部感染、气道分泌物量在中量以上、给予密闭式吸痰患者分成A、B、C三组，各40例。A组为浅部吸痰法，即将密闭式吸痰管插入气管插管或气管套管的长度短1 cm；B组为深部吸痰法，即将密闭式吸痰管插入气管，当感觉到有阻力时，再上提1 cm；C组为标准吸痰法，即密闭式吸痰管插入气管插管或气管切开套管口后再延长1 cm，观察比较三组吸痰前后吸痰有效性指标及安全性指标。结果 B、C组吸痰前后有效性指标优于A组，差异有统计学意义（P＜0.05）；A、C组吸痰前后安全性指标优于B组，差异有统计学意义（P＜0.05）。结论标准吸痰法可有效清除气道分泌物，具有较好的安全性和有效性，同时引发的并发症较少。