密闭式吸痰技术在危重患儿机械通气中的应用与护理

摘要

目的 危重患儿机械通气中使用密闭式吸痰技术的应用研究探讨.方法 选择在ICU需行机械通气的危重患儿40例,随机分为对照组和实验组,对照组20例采用开放式吸痰技术,实验组20例采用密闭式吸痰技术,观察两组吸痰前后血氧饱和度、心率、平均动脉压、气管粘膜损伤等情况.结果 实验组与对照组相比,吸痰前2 min血氧饱和度、心率、平均动脉压等指标间差异无统计学意义(P＞0.05).吸痰后2 min血氧饱和度明显升高,心率、平均动脉压明显降低(P＜0.05).结论 密闭式吸痰技术能减轻患儿机械通气由吸痰引起的低氧血症,并维持稳定的血流动力学,减少机械通气时间及气管粘膜损伤;患儿机械通期间吸痰过程安全,护理人员操作简便.%Objective To explore the nursing application of closed endotraeheal suctioning for mechanical ventilation in children with severe disease.Methods Forty in-patients children with severe disease were randomly divided into experimental group with closed endotraeheal suctioning and control group with traditional open suctioning.Several indicators,such as SpO2,heart rate (HR),blood pressure,and rate of airway mucosa injury were evaluated between two groups.Results There were no significant difference in SpO2,HR,and blood pressure between experiment and control group 2 min before endotraeheal suctioning.Decreased SpO2 (P ＜ 0.05),increased blood pressure (P ＜ 0.01) and heart rate (P ＜ 0.01) were found in control group instead of experimental group 2 min after suctioning.Increased rate of airway mucosa injury (P ＜ 0.05) and ventilator-associated pneumonia (VAP) (P ＜ 0.05) had likely taken place in control group subject to experimental group,2 min after endotraeheal suction.Conclusion Closed endotraeheal suctioning can alleviate the lower SpO2,maintain the balance of blood flow,ease the injury in airway mucosa,and decrease infectious rate of airway which help to improve life quality of children with severe disease and facilitate operational procedure of nursing.