小儿深麻醉下气管内吸痰法评价

摘要

目的 探讨深麻醉状态下拔除气管导管后,将吸痰管插入气管内吸痰,清理呼吸道的吸痰方法.方法 50例患儿随机分为两组:实验组,深麻醉状态下拔除气管导管后将吸痰管插入气管内进行吸痰；对照组,采用传统气管导管内吸痰方法吸痰.比较两组患儿吸痰有效率,观察血氧饱和度、血压、心率的变化以及有无恶心、呕吐、躁动、喉痉挛、支气管痉挛等并发症的发生.结果 实验组吸痰有效率高于对照组(P＜0.05).吸痰前,两组SpO2 、BP、HR差异无统计学意义(P＞0.05)；吸痰后,对照组BP、HR明显升高(P＜0.05),恶心、呕吐发生率差异无统计学意义(P＞0.05),对照组发生 躁动明显升高(P＜0.05).结论 深麻醉状态下拔除气管导管后,将吸痰管插入气管内吸痰的方法能彻底清除呼吸道潴留的痰液,效果明显优于传统气管导管内吸痰法；同时能改善肺的通气功能,预防术后肺部感染及肺不张的发生；由于在深麻醉下进行操作,大大地减少了心血管系统反应,降低恶心、呕吐、躁动、喉痉挛、支气管痉挛等并发症的发生,是一项保障麻醉安全,提高患儿术后生活质量的有效方法.%Objective To discuss measures of sputum aspiration by airway clearance after removing tracheal catheter during deep anesthesia condition. Methods 30 cases of pediatric patients are divided into two groups at random, experimental group, inserting sputum aspiration tubes into trachea after removing tracheal catheter during deep anesthesia condition; control group, traditional endotracheal sputum aspiration. Compare effective rates of sputum aspiration in two groups, to observe oxyhemo- . Globin saturation, blood pressure, heart rate and whether having or not complications such as nausea, vomiting, dysphoria, laryng-ismus, bronchial spasm. Results The effective rate of experimental group is higher than that of the control group ( P < 0.05 ). Before sputum aspiration, SpO2^BP,HR of two groups are not significantly different(P>0.05) ; after sputum aspiration, SpO2N BP and HR of two groups are significantly different(P<0.05) , the rates of nausea, vomiting are not significantly different(P >0. 05); rates of dysphoria in control group are significantly different ( P < 0.05 ). Conclusion That measure of sputum aspiration airway by airway clearance after removing tracheal catheter during deep anesthesia condition is the effective way ,it can clear retention of sputum completely and it is better than traditional one. The former improve ventilation function, prevent atelectasis and reduce pulmonary infection. Because operating under deep anesthesia, it can decrease reacion of cardiovascular system, reduce complications such as nausea, vomiting, dysphoria, laryngismus, bronchial spasm and promote quality of life among pediatric patients after operations.