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目的:探讨昏迷致上呼吸道梗阻置入鼻咽通气管患者安全有效的气道湿化方式。方法:采用前瞻性、随机的方法将104例昏迷致上呼吸道梗阻置入鼻咽通气管患者按是否持续氧气雾化吸入分为实验组(经鼻咽通气管氧气雾化吸入)和对照组(经鼻咽通气管氧气吸入)。每组各52例,分别记录两组痰液黏稠度、堵管、治疗后30min、60min、120min脉搏血氧饱和度(SpO2)、治疗2h后缺氧症状体征改善情况。结果:两组痰液黏稠度及堵管比较中Ⅱ度痰液黏稠度实验组高于对照组(P<0.01);Ⅲ度痰液黏稠度实验组低于对照组(P<0.05);鼻咽通气管无堵塞实验组高于对照组(P<0.01);发生轻度及中度堵塞实验组低于对照组(P<0.05);实验组比对照组在氧气雾化吸入后30min、60minSpO2明显升高(P<0.01);实验组在氧气雾化吸入后60min比治疗前SpO2明显升高(P<0.01);实验组治疗2h后缺氧症状体征改善情况明显优于对照组(P<0.01)。结论:昏迷致上呼吸道梗阻置入鼻咽通气管患者,采用持续氧气雾化吸入,解除上呼吸道梗阻的同时将氧疗、雾化有机地结合起来,能降低痰液黏稠度,减少堵管,迅速提高血氧饱和度,缺氧症状体征改善明显,值得临床推广使用。
Objective: To investigate the safe and effective way of airway humidification in patients with nasopharyngeal airway caused by upper respiratory tract obstruction caused by coma. Methods: A prospective, randomized method was used to divide 104 patients with upper respiratory tract obstruction into the nasopharyngeal airway into the nasal pharyngeal airway. The patients were divided into the experimental group (aerosol inhalation via nasopharyngeal airway tube) and the control group Nasal pharyngeal airway oxygen inhalation). Each group of 52 patients were recorded two groups of sputum viscosity, blocking, after treatment 30min, 60min, 120min pulse oximetry (SpO2), 2h after treatment of hypoxia symptoms and signs of improvement. Results: The viscosity of the sputum in both groups was significantly higher than that in the control group (P <0.01). The viscosity of the sputum in group Ⅲ was lower than that in the control group (P <0.05) Compared with the control group, the pharyngeal ventilation tube in the experimental group without clogging was higher than the control group (P <0.01), mild and moderate occlusion in the experimental group was lower than that in the control group (P <0.05) (P <0.01). In the experimental group, SpO2 was significantly increased at 60 min after inhalation of oxygen (P <0.01), and the improvement of signs of hypoxia in the experimental group was significantly better than that of the control group (P < 0.01). CONCLUSION: Coma caused by upper respiratory tract obstruction in nasopharyngeal airway tube patients, continuous oxygen atomization inhalation to relieve upper airway obstruction while oxygen therapy, atomization and organic combination can reduce the viscosity of sputum, reduce the tube plugging, Rapidly improve the oxygen saturation, hypoxia symptoms improved significantly, it is worth promoting the use of clinical.