密闭浅层呼吸机膨肺吸痰法在心脏术后患者中的应用及效果评价

朱纪荣; 刘丹丹; 葛建军

doi:10.16766/j.cnki.issn.1674-4152.002661

密闭浅层呼吸机膨肺吸痰法在心脏术后患者中的应用及效果评价

doi: 10.16766/j.cnki.issn.1674-4152.002661

1.
中国科学技术大学附属第一医院南区心脏大血管外科重症监护室，安徽合肥 230036
2.
中国科学技术大学附属第一医院心脏大血管外科

基金项目:

安徽省自然科学基金项目 2008085MH240

详细信息

通讯作者:
葛建军, E-mail: anyigejj@163.com

中图分类号: R654.2 R473
计量
- 文章访问数: 108
- HTML全文浏览量: 69
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2022-05-16
- 网络出版日期: 2022-11-29

Application and effect evaluation of airtight shallow ventilator lung dilated suction in postoperative cardiac patients

1.
Intensive Care Unit, Department of Cardiac and Macrovascular Surgery, the First Affiliated Hospital of University of Science and Technology of China, South Zone. Hefei, Anhui 230036, China

摘要

摘要: 目的探讨密闭浅层呼吸机膨肺吸痰法在心脏术后患者中的应用及效果，旨在为心脏术后患者吸痰方式的选择提供参考。方法以2020年2—8月中国科学技术大学附属第一医院收治的心脏术后患者221例为研究对象，采用随机数字表法分为对照组和观察组，对照组110例给予传统膨肺吸痰，观察组111例给予密闭浅层呼吸机膨肺吸痰。比较2组患者的机械辅助通气时间、吸痰后的心率恢复时间、末梢血氧饱和度恢复时间及痰鸣音改善评分。结果对照组患者的机械通气时间为(11.93±5.83)h，观察组为(9.92±3.61)h，2组比较差异有统计学意义(t=3.083，P＜0.05);观察组心脏术后患者吸痰结束后的心率恢复时间、血氧饱和度恢复时间均明显低于对照组(t=2.707、4.591，均P＜0.05);对照组患者痰鸣音改善评分为(2.69±0.55)分，观察组为(2.86±0.35)分，2组比较差异有统计学意义(t=2.641，P＜0.05)。结论与常规人工膨肺吸痰比较，密闭浅层呼吸机膨肺吸痰法可缩短成人心脏术后患者的机械通气时间，稳定患者的生命体征并改善术后患者的痰鸣音情况，推荐密闭浅层呼吸机膨肺吸痰作为此类患者气管内吸痰的优选方法。
- 成人心脏病 /
- 外科手术 /
- 吸痰 /
- 方法研究
Abstract: Objective During cardiac surgery, the lung is inevitably affected by cardiac surgery because the surgery requires incision of the sternum and disrupts the continuity of the sternum. Cardiac surgery is time-consuming, resulting in longer alveolar collapse time during surgery, which requires higher requirements for postoperative airway care. This study investigates the application and effect of airtight shallow ventilator lung dilated suction in postoperative cardiac patients, aiming to provide reference for the selection of suction method for postoperative cardiac patients. Methods A total of 221 postoperative cardiac patients admitted to the First Hospital of the University of Science and Technology of China from February 2020 to August 2020 were taken as the study subjects. They were divided into control group (110 cases) and observation group (111 cases) using random number table method. The patients in the control group were given conventional lung dilated suction and patients in the observation group were given airtight shallow ventilator lung dilated suction. The mechanical assisted ventilation time, heart rate recovery time after suctioning, terminal oxygen saturation recovery time and sputum sound improvement scores of the patients in the two groups were compared. Results The time of mechanical ventilation was (11.93±5.83) h in the control group and (9.92±3.61) h in the observation group, and the difference was statistically significant (t=3.083, P < 0.05). The heart rate recovery time and oxygen saturation recovery time after the end of sputum aspiration in patients in the observation group after cardiac surgery were significantly lower than those in the control group (t=2.707, 4.591, all P < 0.05). The sputum sound improvement score was (2.69±0.55) points in the control group and (2.86±0.35) points in the observation group, and the difference was statistically significant (t=2.641, P < 0.05). Conclusion Compared with conventional manual lung dilated suction, airtight shallow ventilator lung dilated suction can shorten the duration of mechanical ventilation in adult postoperative cardiac patients, stabilize the patients'vital signs and improve the sputum sound in postoperative patients. Airtight shallow ventilator lung dilated suctioning is recommended as the preferred method of endotracheal suctioning in these patients.
- Adult heart disease /
- Surgery /
- Sputum aspiration /
- Method study

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表 1 2组心脏术后患者一般资料比较

Table 1. Comparison of general data between the two groups of patients after cardiac surgery

组别	例数	年龄(x±s，岁)	性别(例)		手术类型(例)
组别	例数	年龄(x±s，岁)	男性	女性	瓣膜置换	冠脉搭桥	主动脉夹层
对照组	110	57.25±12.47	63	47	69	38	3
观察组	111	57.05±11.83	64	47	69	38	4
统计量		0.117^a	0.990^b		1.125^b
P值		0.907	0.610		0.771
注：^a为t值，^b为χ²值。

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表 2 2组心脏术后患者相关指标及评分比较(x±s)

Table 2. Comparison of related indexes and scores of patients after cardiac surgery between the two groups (x±s)

组别	例数	机械通气时间(h)	心率恢复时间(s)	血氧饱和度恢复时间(s)	痰鸣音改善评分(分)
对照组	110	11.93±5.83	46.90±11.00	20.07±4.21	2.69±0.55
观察组	111	9.92±3.61	43.28±8.77	17.63±3.68	2.86±0.35
t值		3.083	2.707	4.591	2.641
P值		0.002	0.007	＜0.001	0.009

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