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find Keyword "吸痰" 9 results
  • 不同密闭式吸痰方法在ARDS患者中的应用比较

    摘要:目的:探讨密闭式吸痰时高氧疗和/或肺泡复张术对急性呼吸窘迫综合征(ARDS)患者吸痰后的应用和影响。方法:建立人工气道行机械通气的ARDS患者42例,随机分为研究组和对照组各21例,对照组采用高氧法密闭式吸痰即吸痰时高氧供吸痰前1 min给予100%氧供并贯穿整个吸痰过程共持续2 min(高氧法);研究组采用高氧 复张法(结合法) 即采用高氧法与复张法密闭式吸痰方法吸痰,复张法即吸痰后即刻调节PEEP 水平到2.0 kPa(20 cm H2O),通气10 s。观察吸痰前1 min、吸痰后1、3 min患者呼吸力学及血气的变化,并记录两组患者的机械通气时间、气压伤、肺不张和肺部感染的发生率。结果:两组患者吸痰前血流动力学、动脉血气、呼吸力学各参数比较,均无显著性差异(Pgt;0.05),吸痰后除心率变化无显著性差异外(Pgt;0.05),其余各项指标、两组机械通气时间、肺不张和肺部感染发生率差异均有显著性(Plt;0.05)。高氧法吸痰后1 min PaO2、SaO2 较基线水平有所升高, 结合法吸痰后3 min PaO2、SaO2 升高(Plt;0.05) 。结论:高氧法可短暂改善密闭式吸痰所引起的缺氧,对ARDS机械通气患者给予结合法吸痰能够保持吸痰前后全过程较好氧合状态,纠正吸痰所导致的低氧,改善肺的顺应性,并能缩短机械通气时间、降低肺不张和肺部感染发生率。

    Release date:2016-08-26 03:57 Export PDF Favorites Scan
  • Closed versus Open Tracheal Suction Systems for Ventilator-associated Pneumonia in Adults: A Systematic Review

    Objective To determine the effect of closed tracheal suction system versus open tracheal suction system on the rate of ventilator-associated pneumonia in adults. Methods We searched The Cochrane Library (Issue 1, 2007), PubMed (1966 to 2006) and CBM (1980 to 2007), and also hand searched relevant journals. Randomized controlled trials involving closed tracheal suction system versus open tracheal suction system for ventilator-associated pneumonia in adults were included. Data were extracted and the quality of trials was critical assessed by two reviewers independently. The Cochrane Collaboration’s RevMan 4.2.8 software was used for data analyses. Result Five randomized controlled trials involving 739 patients were included. Results of meta-analyses showed that compared to open tracheal suction system, closed tracheal suction system did not increase the rate of ventilator-associated pneumonia (RR 0.83, 95%CI 0.50 to 1.37) or case fatality (RR 1.05, 95%CI 0.85 to 1.31). No significant differences were observed between open tracheal suction system and closed tracheal suction system in the total number of bacteria (RR 0.83, 95%CI 0.50 to 1.37), the number of SPP colony (RR 2.87, 95%CI 0.94 to 8.74) and the number of PSE colony (RR 1.46, 95%CI 0.76 to 2.77). There was no significant difference between the two groups in the duration of ventilation and length of hospital stay. Conclusion Open or closed tracheal suction systems have similar effects on the rate of ventilator-associated pneumonia, case fatality, the number of SPP and PSE colonies, duration of ventilation and length of hospital stay. However, due to the differences in interventions and statistical power among studies included in this systematic review, further studies are needed to determine the effect of closed or open tracheal suction systems on these outcomes.

    Release date:2016-09-07 02:12 Export PDF Favorites Scan
  • Clinical Study of Two Suctioning Methods on the Prevention of Respiratory Tract Infection in Mechanically Ventilated Patients after Cardiac Surgery

    【摘要】 目的 探讨密闭式吸痰和开放式吸痰两种方式对预防心胸外科术后机械通气患者呼吸道感染的效果。 方法 2009年9月-2010年8月,将86例心胸外科术后机械通气患者随机分为两组,试验组应用密闭式吸痰法,对照组采用开放式吸痰法。观察两组患者术后机械通气治疗即刻及至拔出气管插管后48 h内每日痰培养结果、每4小时监测一次体温、血常规检查及胸片结果、呼吸机相关性肺炎(ventilator associated pneumonia,VAP)发生情况。 结果 两组患者在年龄、性别、病种方面差异均无统计学意义(Pgt;0.05),但痰培养结果阳性率、VAP发生率差异均有统计学意义(Plt;0.05)。两组发生VAP患者的痰培养病原菌检出情况:试验组均为G-菌;对照组以G-菌为主,余者为真菌-白色念珠菌。 结论 密闭式吸痰法预防心胸外科术后机械通气患者呼吸道感染效果较开放式吸痰法好。G-菌和真菌-白色念珠菌耐药性强,治疗难度大,临床中应重视呼吸道感染的预防。【Abstract】 Objective To evaluate the effects of closed endotracheal suctioning (CS) and open endotracheal suctioning (OS) on the prevention of respiratory tract infection in mechanically ventilated patients after cardiac surgery. Methods From September 2009 to August 2010, 86 mechanically ventilated patients after cardiac surgery were randomly divided into two groups. CS and OS were provided for patients in the experimental group and the control group, respectively. The sputum culture result, body temperature every four hours, blood routine examination and chest X-ray result, and the development of ventilator-associated pneumonia (VAP) were observed and compared between the two groups at the admission to the ICU and once a day thereafter. Results There were no significant differences between the two groups in sex, age, or kinds of diseases (Pgt;0.05). There were significant differences between the two groups in the positive rate of sputum culture results and the incidence of VAP (Plt;0.05). The pathogens isolation in sputum culture of VAP patients were all Gram-negative bacteria in the experimental group, and mainly Gram-negative bacteria followed by fungi-Blastomyces albicans in the control group. Conclusions CS is more effective than OS in the prevention of respiratory tract infection in mechanically ventilated patients after cardiac surgery. The drug resistance of Gram-negative bacteria and fungi-Blastomyces albicans is b, and the treatments of those bacteria are difficult. Thereafter, we should pay more attention to the prevention of respiratory tract infection.

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
  • 封闭式吸痰管在气管切开患者中的应用与护理

    【摘要】 目的 总结封闭式吸痰管在气管切开患者应用过程中的价值。 方法 2008年7月-2009年7月对60例气管切开患者,使用封闭式吸痰管进行吸附痰液,并根据临床观察情况予以护理。 结果 封闭式吸痰管有利于减轻患者肺部并发症、降低吸痰所引起的血液动力学的改变、防止交叉感染,减轻了护士工作量及提高了护理质量。 结论 封闭式吸痰管适用于气管切开患者的临床应用与推广。

    Release date:2016-09-08 09:51 Export PDF Favorites Scan
  • 消毒后吸痰用储液瓶重复使用保存时间探讨

    目的探讨可重复使用消毒吸痰用储液瓶的保存时限,为临床安全使用提供依据,减少不必要浪费。 方法2014年1月-2015年6月,供应室集中清洗、酸化电位水浸泡消毒、干燥处理后的储液瓶采用市购的自封塑料袋独力包装后,随机分为A组(n=240)和B组(n=240),A组分别储存于临床各科室的抢救室塑料袋内,B组存放在供应室无菌物品存放间,储存环境温度均为22~25℃,湿度为50%~70%,采样监测消毒后1~40 d储液瓶细菌污染情况。 结果A组分别于第14、28天各检出1个储液瓶污染,污染的储液瓶自封塑料袋封口处密闭性破坏;30 d后自封塑料袋封口处密闭性未破坏情况下开始检出污染储液瓶。B组36 d内未出现污染。 结论为便于全院统一管理,使用独立包装消毒备用存放在临床科室抢救室的消毒后吸痰用储液瓶和存放在供应室的消毒后吸痰用储液瓶保存有效期建议为30 d,一旦发现独立包装密闭性破坏则不得使用。

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  • 胸部物理疗法联合口咽通气管吸痰在支气管扩张症无创通气中的应用

    目的 探讨胸部物理疗法联合口咽通气管吸痰对行无创正压通气的支气管扩张症患者的治疗效果及安全性。 方法 选取 2013 年 1 月—2015 年 8 月存在不同程度急性呼吸衰竭的急性加重期支气管扩张症患者 27 例,在给予抗菌药物治疗、对症治疗、营养支持的基础上行无创正压通气,护理上给予手法叩背、应用体外震动排痰机、体位引流等胸部物理疗法联合经口咽通气管吸痰。 结果 经综合治疗和护理后,患者最终显效 16 例,有效 9 例,无效 2 例,治疗有效率达 92.6%。 结论 对伴有呼吸衰竭的支气管扩张症急性加重期患者,在实施无创正压通气时,用胸部物理疗法配合口咽通气管吸痰能解决无创正压通气中患者无力咳痰的问题,保持呼吸道通畅,保障无创正压通气的顺利实施,改善患者预后。

    Release date:2017-08-22 11:25 Export PDF Favorites Scan
  • 清醒志愿者被经口鼻腔吸痰的心理体验

    目的 深入了解清醒志愿者被吸痰期间的心理体验,为临床护理人员采取针对性的护理措施提供依据。 方法 2016 年 3 月 12 日,采用自我体验加质性研究方法,研究者及7名学生作为志愿者亲自体验被吸痰的过程,吸痰后对 8 名志愿者进行深入访谈,采用 Colaizzi 分析法进行资料分析。 结果 经口鼻腔吸痰的心理体验包括:被吸痰前的期望体验和对被吸痰的恐惧,被吸痰时极度不舒适,被吸痰后体会到该如何体贴爱护患者。 结论 针对清醒患者的吸痰,护士应该更多地给予安慰和鼓励,重视患者和家属的心理支持,采用多种措施减少负性体验;采用体验式教学可增加护生的爱伤意识。

    Release date:2017-10-27 11:09 Export PDF Favorites Scan
  • A Meta analysis on effects of different sputum suction time

    ObjectiveTo analyze the effects of time-worn ritual endotracheal suction (TRES) and on-demand invasive airway suction (OIAS) for patients.MethodsPubMed, EMBASE, Cochrane Library, Web of Science, EBSCO, CBM, CNKI, WanFang and VIP databases were searched for all randomized controlled trials (RCTs) comparing TRES with OIAS for patients. The studies were selected according to inclusion and exclusion criteria. The articles were assessed and data were extracted from them. The RevMan 5.3 software was used to analyze the data.ResultsSeventeen randomized controlled trials were included finally, and 2 029 patients were included, involving 1 028 patients in the control group and 1 001 patients in the experimental group. The results of meta-analysis showed that compared with TRES, OIAS could reduce the damage to the airway mucosa injury (RR=0.18, 95%CI 0.13 - 0.26, P<0.000 01), reduce secondary respiratory infections (RR=0.44, 95%CI 0.30 - 0.65, P<0.000 1), decrease the occurrence of phlegm blockade (RR=0.20, 95%CI 0.13 - 0.33, P<0.000 01), shorten the hospital stay (MD=5.03, 5%CI 3.17 - 6.89, P<0.000 01), but not influence the drop in oxygen saturation and the drop in blood oxygen pressure (RR=0.50, 95%CI 0.21 - 1.17, P=0.11). However there was no significant difference in mortality between two groups (P=0.46).ConclusionOIAS is preferred for patients who need suction than TRES.

    Release date:2019-09-25 09:48 Export PDF Favorites Scan
  • Efficacy of closed and open tracheal suction systems for prevention of ventilator-associated pneumonia: a meta-analysis

    ObjectiveTo systematically review the efficacy of closed and open tracheal suction system on the prevention of ventilator-associated pneumonia.MethodsThe Cochrane Library, CNKI, WanFang Data, Airiti Library, PubMed, CINAHL and Proquest databases were electronically searched to collect randomized controlled trials (RCTs) on closed and open tracheal suction system on the prevention of ventilator-associated pneumonia. Two reviewers independently screened literature, extracted data, and assessed the risk bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 11 RCTs involving 1 187 patients were included. The results of meta-analysis showed that compared with open tracheal suction system, closed tracheal suction system was associated with a reduced incidence of ventilator-associated pneumonia (RR=0.55, 95%CI 0.44 to 0.67, P<0.000 01), late-onset ventilator-associated pneumonia (RR=0.47, 95%CI 0.28 to 0.80, P=0.005), length of stay in intensive care unit (MD=−0.85, 95%CI −1.66 to −0.04, P=0.04) and rate of microbial colonization (RR=0.69, 95%CI 0.56 to 0.86, P=0.000 9). However, there were no significant differences between two groups in time to ventilator-associated pneumonia development (MD=0.96, 95%CI −0.21 to 2.12, P=0.11), length of mechanical ventilation (MD=−2.24, 95%CI −4.54 to 0.06, P=0.06), and rate of mortality (RR=0.88, 95%CI 0.73 to 1.05, P=0.15).ConclusionsCurrent evidence shows that compared with open tracheal suction system, closed tracheal suction system can reduce the incidence of ventilator-associated pneumonia and late-onset ventilator-associated pneumonia, shorten the hospital stay in intensive care unit, and reduce rate of microbial colonization. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

    Release date:2021-02-05 02:57 Export PDF Favorites Scan
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