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目的探讨经鼻留置吸痰管于气管内按需吸痰辅助治疗重症支气管扩张症患者的临床疗效。方法将符合条件的61例患者随机分为对照组30例和观察组31例,对照组按常规给予抗生素、对症支持、雾化吸入、体位引流,观察组在此基础上给予气管内留置吸痰管,通过留置吸痰管向气管内注入气道湿化液,根据需要从留置吸痰管内按需吸痰。以动脉血氧分压、动脉血二氧化碳分压、咳嗽、咳痰、呼吸困难、住院天数、行机械通气例数为观察指标。结果经治疗后,对照组患者入院96 h氧分压(75.1±3.3)mm Hg(1 mm Hg=0.133 k Pa),入院96 h二氧化碳分压(52.4±3.4)mm Hg,入院120 h氧分压(78.6±4.7)mm Hg,入院120 h二氧化碳分压(51.8±3.9)mm Hg;与观察组的入院96 h氧分压[(79.8±5.4)mm Hg]、入院96 h二氧化碳分压[(49.1±2.8)mm Hg]、入院120 h氧分压[(84.9±4.4)mm Hg]、入院120 h二氧化碳分压[(48.3±2.2)mm Hg]比较差异有统计学意义(P<0.01);对照组呼吸困难(2.78±0.47)分,与观察组的(2.43±0.39)分比较,差异有统计学意义(P<0.01);对照组患者住院天数为(21.93±4.87)d,行机械通气5例;观察组患者住院天数(16.55±3.71)d,机械通气0例,两组比较差异有统计学意义(P<0.01或<0.05)。结论重症支气管扩张症患者经鼻留置吸痰管按需吸痰对患者有辅助治疗作用,能及时解除痰液滞留,保持呼吸道通畅,改善患者的缺氧状态,缩短病程。
Objective To investigate the clinical effect of nasal lavage aspiration tube on intra-tracheal aspiration for sputum aspiration therapy in patients with severe bronchiectasis. Methods A total of 61 eligible patients were randomly divided into control group (n = 30) and observation group (n = 31). Patients in the control group were given routine antibiotics, symptomatic support, nebulized inhalation and body drainage. On the basis of this observation, Tube, through the indwelling suction tube into the trachea airway humidification fluid, as needed, from the indwelling suction tube aspiration on demand. The partial pressure of arterial oxygen, partial pressure of arterial carbon dioxide, cough, sputum, dyspnea, hospitalization days, the number of cases of mechanical ventilation as the observation index. Results After treatment, the patients in the control group were exposed to oxygen for 96 h (75.1 ± 3.3) mm Hg (1 mm Hg = 0.133 k Pa) and were admitted to hospital for 96 h with partial pressure of 52.4 ± 3.4 mm Hg (78.6 ± 4.7) mm Hg, and the partial pressure of carbon dioxide (51.8 ± 3.9) mm Hg 120 h after admission. Compared with the observation group, the 96 h oxygen partial pressure [(79.8 ± 5.4) mm Hg] (49.1 ± 2.8) mm Hg]. The partial pressure of oxygen at 120 h after admission was (84.9 ± 4.4) mm Hg, and the difference was statistically significant at 120 h (48.3 ± 2.2 mm Hg) ) In the control group (2.78 ± 0.47), which was significantly different from that in the observation group (2.43 ± 0.39) (P <0.01). The length of stay in the control group was (21.93 ± 4.87) d Mechanical ventilation in 5 cases; observation group patients hospitalized days (16.55 ± 3.71) d, mechanical ventilation in 0 cases, the difference between the two groups was statistically significant (P <0.01 or <0.05). Conclusions Patients with severe bronchiectasis suction nasal suction tube aspiration on patients with adjuvant therapy, the timely removal of sputum retention, to maintain airway patency, improve patients with hypoxia, shorten the course.