【摘要】 目的:探讨纤维支气管镜定位下递进式吸痰在气管插管机械通气患者的应用效果。方法:选取2018年2月-2019年10月本院ICU的300例气管插管机械通气患者,按照随机数字表法分为对照组与研究组,每组150例。对照组待出现吸痰指征后,采用密闭式吸痰管盲插吸痰,研究组于纤维支气管镜定位下递进式吸痰。比较两组患者吸痰前后的血氧饱和度（SpO₂）、氧合指数（OI）、心率（HR）变化;比较两组患者的吸痰间隔时间、吸痰彻底评分、吸痰舒适度评分及并发症发生情况。结果:研究组吸痰后的SpO₂、OI均高于对照组,HR低于对照组（P<0.05）;研究组吸痰间隔时间及吸痰舒适度评分均显著高于对照组,吸痰彻底评分显著低于对照组（P<0.01）;研究组吸痰后的VAP、SpO₂下降、气道黏膜损伤发生率均低于对照组（P<0.05）。结论:气管插管机械通气患者采用纤维支气管镜定位下递进式吸痰技术,可有效提升吸痰后的血氧饱和度及氧合指数,延长吸痰间隔时间,提升吸痰后舒适感,降低吸痰中的SpO₂下降及气道黏膜损伤发生率,降低吸痰后VAP发生率,值得临床应用。更多还原

【Abstract】 Objective:To explore the efficacy of progressive sputum suction under the position of fiberoptic bronchoscope in patients with mechanical ventilation of tracheal intubation.Method:A total of 300 patients with endotracheal intubation and mechanical ventilation in ICU of our hospital from February 2018 to October 2019 were selected,they were divided into control group and study group according to random number table method,150 patients in each group.The control group was used the blindly inserted sputum suction with closed sputum suction tube after the indication of sputum suction appeared,the study group was used under progressive bronchoscopy of fiber bronchoscope to suction.The blood oxygen saturation （SpO₂）,oxygenation index （OI）,heart rate （HR） changes of ICU patients before and after suctioning were compared between the two groups;the suction interval time,sputum suction score score,sputum comfort score and complications of the two groups were compared.Result:SpO₂ and OI of the study group after sputum aspiration were higher than those of the control group,while HR was lower than that of the control group （P<0.05）;the sputum aspiration interval time and sputum aspiration comfort score in the study group were significantly higher than those in the control group,and the sputum aspiration thorough score was significantly lower than that in the control group （P<0.01）;the incidence of VAP,SpO₂ decrease and airway mucosal injury in the study group were lower than those in the control group （P<0.05）.Conclusion:Endotracheal intubation in patients with mechanical ventilation with progressive type sputum suction under the fiber bronchoscope positioning technology,can effectively improve the sputum suction oxygen saturation and oxygenation index,extend the sputum suction time interval,after ascending sputum suction comfort,reduce the SpO₂ decline in the sputum suction and the incidence of airway mucosa damage,reduce the incidence of VAP after sputum suction,worthy of clinical application.更多还原