摘要
目的评价自制口鼻面罩下无创正压通气辅助支气管镜吸痰的应用效果。方法选择2011年10月-2012年10月我院呼吸科监护病房使用无创机械通气排痰困难患者33例,随机分为口鼻面罩组15例和对照组18例。口鼻面罩组采用经自制口鼻面罩下无创正压通气辅助支气管镜吸痰;对照组采取传统吸痰方式,即直接摘下面罩吸痰。记录两组患者在吸痰前、进镜过程中、吸痰中、吸痰结束时、吸痰结束后10 min的心率、呼吸频率、平均血压、脉氧饱和度。同时在吸痰前和吸痰结束时检测患者动脉血气水平。结果两组性别、年龄、急性生理学及慢性健康状况(APACHEⅡ)评分比较差异无统计学意义(P>0.05)。口鼻面罩组在吸痰过程中各个时间点心率和呼吸频率始终低于对照组,脉氧饱和度始终高于对照组(P<0.05)。吸痰结束时,口鼻面罩组的pH、PaO2明显高于对照组,PaCO2明显低于对照组(P<0.05)。结论经自制的改良口鼻面罩下无创正压通气辅助支气管镜吸痰能够使患者呼吸频率、脉氧饱和度和动脉血气保持在一个较为稳定的水平,安全性高、应用价值大。
Objective To evaluate the clinical efficacy of noninvasive positive pressure ventilation-assisted branchoscopy sputum suction in patients wearing homemade nose and mouth mask. Methods Thirty-three patients with difficult expectoration who underwent noninvasive mechanical ventilation in our hospital from October 2011 to October 2012 were randomly divided into nose and mouth mask group （n=15） and control group （n=18）. Patients in nose and mouth mask group wearing homemade nose and mouth mask underwent noninvasive positive pressure ventilation-assisted bronchoscopy sputum suction and those in control group received traditional sputum suction, namely the mask was removed when sputum was sucked. Their heart rate, respiratory rate, mean blood pressure, and pulse oxygen saturation were recorded before and during sputum suction, bronchoscope entering, at the end of and 10 min after sputum suction and their arterial blood gas level was measured. Results No significant difference was observed in gender, age, and APACHE Ⅱ score between the two groups （P 〉 0.05）. The heart and respiratory rate were lower whereas the pulse oxygen saturation was higher in nose and mouth mask group than in control group at different time points of sputum suction （P 〈 0.05）. The pH and PaO 2 were significantly higher whereas the PaCO 2 was significantly lower in nose and mouth mask group than in control group （P 〈 0.05）. Conclusion Non-invasive positive pressure ventilation-assisted bronchoscopy sputum suction can maintain the relatively stable respiratory rate, pulse oxygen saturation and arterial blood gas levels in patients wearing homemade nose and mouth mask with a high safety and is thus of a promise application value.
出处
《解放军医学院学报》
CAS
2013年第11期1164-1166,共3页
Academic Journal of Chinese PLA Medical School
关键词
无创机械通气
气管镜
吸痰
non-invasive mechanical ventilation
bronchoscopy
suction
