不同负压吸痰在ARDS病人中的应用研究

目的 比较两种吸痰负压对急性呼吸窘迫综合征(ARDS)病人血氧饱和度(SPO2)、平均气道压和心率(HR)的影响,为选择合适的吸痰负压提供参考.方法 建立人工气道行机械通气ARDS病人42例,每例病人均使用小负压(10～20kpa)和大负压(20～30kpa)吸痰,吸痰负压顺序随机选择.观察病人在不同吸痰负压下,吸痰前、吸痰后即刻、吸痰后15s、30s、1min的SPO2、平均气道压和HR的变化,记录SPO2下降的最大值、下降至最低值的时间、恢复至基线的时间.结果 两种负压吸痰前后病人SPO2、平均气道压和HR比较,无显著性差异(P>0.05);两种负压吸痰后SPO2下降的最大值、下降至最低值的时间比较,无显著性差异(P>0.05);大负压吸痰SPO2恢复至基线的时间显著延长(P<0.05).结论 两种负压吸痰均能引起ARDS病人SPO2相对下降,HR相对升高.建议ARDS病人采用小负压吸痰,以缩短SPO2恢复至基线的时间.

The Application Research of Different Negative Pressure sputum Aspiration on the Patients with ARDS

Objective To compare the influence of two different ways of negative pressure sputum aspiration on pulse oxygen saturation(SPO2)、average airway pressure and heart rate of patients with acute respiratory distress syndrome(ARDS),and to find out an appropriate negative pressure for sputum aspiration. Methods 42 ARDS patients accepting mechanical ventilation treatment were selected.Each was using low negative pressure(10～20.0kpa) and high negative pressure(20.0～30kpa) to aspirate sputum.And sputum aspiration method was chosen randomly in sequence.And investigate the changes of SPO2 、average airway pressure and heart rate changes of patients at different negative pressure before and after sputum aspiration.Record the maximum decreasing of SPO2,the time of down to the lowest value,and the time returned to the baseline of SPO2 of all patients. Results There were no statistically significant differences in the changes of SPO2、average airway pressure and heart rate of patients who accepted two ways of negative pressure sputum aspiration(P>0.05).In terms of the maximum decreasing of SPO2,the time of down to the lowest value,there were no statistical significance differences in patients after accepting the two ways of negative pressure aspiration(P>0.05).But the mean time of SPO2 returned to baseline in patients accepting high negative pressure aspiration was trended to be prolonged(P<0.05). Conclusion Two different ways of sputum aspiration for ARDS patients may cause their SPO2 decline to different degrees,heart rate relative rise.Suggest using low negative pressure to aspirate sputum of patients with ARDS to shorten the time of SPO2 returned to baseline.