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目的探讨重症监护病房患者气管切开术后有效吸痰的时机和方法。方法将32例ICU重症患者随机分为对照组和观察组各16人,对照组采用常规吸痰方法,以听取患者咳嗽声音判断痰液量进行吸痰,吸痰时使用一条吸痰管,先吸气管切开处,后吸口鼻腔。观察组采用改进的吸痰方法进行吸痰,在听诊气道有明显痰鸣音且患者血氧饱和度在95%以下时再进行吸痰,吸痰方法为先吸鼻腔,再吸口腔,后吸气管切开处,吸痰时使用两条吸痰管。结果观察组在日吸痰次数、痰液量、呼吸道黏膜损伤、吸痰后5 min血氧饱和度值、肺部感染发生率等方面与对照组比较差异有统计学意义(P<0.05)。结论重症患者气管切开术后,规范的评估患者,掌握吸痰时机,使用正确的吸痰方法,可降低气管切开早期患者肺部感染发生率,维持肺部正常通气功能,提高气道管理水平,改善患者预后。
Objective To investigate the timing and methods of effective suctioning after tracheotomy in intensive care unit patients. Methods Thirty-two ICU critically ill patients were randomly divided into control group and observation group, 16 in each group. The control group was treated by conventional suction method to listen to the cough sound to determine the amount of sputum. A suction tube was used for sputum aspiration. Inspiratory tube incision, mouth suction nasal cavity. In the observation group, suctioning was performed with the improved suctioning method. In the auscultatory airway, there was obvious phlegm and the patient’s blood oxygen saturation was less than 95%. The suctioning method was aspiration of nasal cavity, then oral cavity, Inspiratory tube incision, suction when using two suction tube. Results There were significant differences between the observation group and the control group in the number of sputum suction, sputum volume, respiratory mucosal injury, blood oxygen saturation 5 min after sputum aspiration, incidence of pulmonary infection and so on (P <0.05). Conclusion Severe tracheotomy patients, standardized assessment of patients, to grasp the timing of suction, the use of the right suction method can reduce the incidence of pulmonary infection in patients with early tracheotomy, to maintain normal lung function, improve airway management Level, improve patient prognosis.