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目的探讨密闭式气管内吸痰对急性呼吸窘迫综合症(acute respiratory distress syndrome,ARDS)患者血流动力学的影响。方法选取2013年1月—2015年1月收治的80例ARDS患者作为研究对象,随机分为对照组和观察组各40例。对照组采用开放式吸痰,观察组采用密闭式气管内吸痰进行治疗。比较两组患者血液流变学指标变化情况及不良反应发生情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗后,观察组低切全血黏度、高切全血黏度、血浆黏度、RBC压积、血小板黏附率分别为(9.21±0.22)、(3.98±0.57)、(1.37±0.20)m Pa·s、(16.1±2.9)mm/h、(43.03±5.14)%、(24.69±4.15)%,对照组分别为(11.83±0.16)、(4.35±0.57)、(1.61±0.23)m Pa·s、(17.1±2.6)mm/h、(45.97±1.58)%、(27.89±2.45)%,两组比较差异均有统计学意义(均P<0.05)。观察组不良反应发生率为12.5%,明显低于对照组的57.5%,差异有统计学意义(P<0.05)。结论密闭式气管内吸痰能有效改善ARDS患者血流动力学,降低不良反应发生率,安全性高,临床效果显著。
Objective To investigate the effects of closed endotracheal suctioning on hemodynamics in patients with acute respiratory distress syndrome (ARDS). Methods Eighty ARDS patients admitted from January 2013 to January 2015 were selected as study subjects and randomly divided into control group and observation group of 40 cases. Control group with open suction sputum, the observation group using closed endotracheal suction sputum for treatment. The changes of hemorheology indexes and adverse reactions in the two groups were compared. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results After the treatment, the whole blood viscosity, the whole blood viscosity, the plasma viscosity, the RBC depressurization and the platelet adhesion rate in the observation group were (9.21 ± 0.22), (3.98 ± 0.57) and (1.37 ± 0.20) m Pa · (11.83 ± 0.16), (4.35 ± 0.57) and (1.61 ± 0.23) m Pa · s in the control group (16.1 ± 2.9) mm / h, 43.03 ± 5.14% and 24.69 ± 4.15% , (17.1 ± 2.6) mm / h, (45.97 ± 1.58)% and (27.89 ± 2.45)%, respectively. There were significant differences between the two groups (all P <0.05). The incidence of adverse reactions in the observation group was 12.5%, which was significantly lower than that in the control group (57.5%), the difference was statistically significant (P <0.05). Conclusion Closed endotracheal suctioning can effectively improve the hemodynamics of patients with ARDS, reduce the incidence of adverse reactions, high safety, the clinical effect is significant.