经鼻气管内吸痰方法及其护理.docVIP

经鼻气管内吸痰方法及其护理[摘要] 目的: 探讨低负压经鼻气管内按需吸痰对老年肺部感染的临床效果。方法：将38例需吸痰的患者随机分为对照组和实验组，各19例，对照组采用常规方法吸痰，实验组采用低负压按需吸痰法。观察两组患者吸痰过程中氧饱和度、呼吸、血性痰液、每日吸痰次数等。结果：实验组吸痰过程中心率、氧饱和度、呼吸较对照组稳定，血痰发生及每日吸痰次数明显降低（P＜0.05）。结论：低负压经鼻气管内按需吸痰可维持较好的血氧饱和度，减少对呼吸道黏膜的机械性损伤，降低患者耗材费用，减轻护理工作量。 [关键词] 经鼻气管内吸痰；肺部感染；护理 [中图分类号] R473.5 [文献标识码] B [文章编号] 1673-7210（2011）11（b）-169-02 Methods and nursing of nasotracheal sputum aspiration LI Shunfang, HE Yingping Department of Respiratory Medicine, the Hospital of Traditional Chinese Medicine of Foshan City, Guangdong Province, Foshan 528000, China [Abstract] Objective: To study the clinical effects of nasotracheal sputum aspiration on demand with low negative pressure in elder patients with pulmonary infection. Methods: 38 patients requiring sputum aspiration were randomly divided into the control group and the experiment group with 19 patients for each group. The control group used conventional methods for sputum aspiration while the experiment group used the method of nasotracheal sputum aspiration on demand with low negative pressure. Oxygen saturation, respiration, bloody sputum, daily frequency of sputum aspiration and others of the two groups during sputum aspiration were observed. Results: The experiment group had steadier heart rate, oxygen saturation and respiration than the control group during sputum aspiration and its frequency of bloody sputum occurrence and daily frequency of sputum aspiration obviously reduced(P0.05）。 1.2方法 1.2.1用物 电动吸痰机一台，一次性无菌吸痰包（内有吸痰管一根、一次性无菌手套一副、一次性治疗巾一张），0.9%生理盐水250 ml。 1.2.2治疗方法 实验组：①患者予双腔氧管给氧，氧气浓度根据医嘱调节，取去枕平卧位，头稍向后仰，颈过伸。②床边心电监测心率、呼吸、氧饱和度。③按鼻腔吸痰法，打开一次性无菌吸痰包，患者胸前铺治疗巾，倾倒生理盐水适量，调节吸痰机负压为0.03~0.04 Mkpa。④戴无菌手套，连接吸痰管，吸生理盐水试吸通畅后，左手返折吸痰管末端，右手持吸痰管前端，右手末指轻柔把双腔氧管稍微向唇部移动，距离可容吸痰管通过，接着沿一侧鼻孔缓慢将吸痰管送入鼻腔内与会厌处之间，左手松开吸痰管末端，右手边吸边旋转吸痰管，吸痰管插入至15~18 cm，相当于成人声门处时，清醒者嘱患者深吸气或咳嗽动作，咳嗽无力或不清醒者助手用手指压迫患者天突穴以刺激气管引起患者咳嗽，患者声门打开时将吸痰管迅速、轻柔地插入主气管处，成人相当于吸痰管插入深度为22~25 cm。在此水平稍停片刻继续旋转吸引，避免在气道内反复上下提插，直至把痰液吸干净。吸痰时间15~45 s。⑤拔管时，当吸痰管退至会厌处时稍停留片刻，把咽喉部的痰液吸干