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目的探讨儿科危重症呼吸道管理中吸痰的合适吸引负压。方法选择41例PICU不能自行排痰的危重症婴幼儿为研究对象。吸引负压预设值为12.5kPa(1 kPa=7.5mmHg),当痰液黏稠不能吸出则以2.5kPa为一个吸引负压单位值逐渐增加为原则,进行吸痰负压的调节,记录痰液吸出情况和有无痰中带血。结果(1)355例次有效吸引,不同吸痰负压时呼吸道黏膜损伤出血间差异有显著性(P<0.001),负压在12.5~17.5kPa是安全的;(2)355例次有效吸引中,不同吸痰负压下痰液的黏稠度比较,差异有显著性(P<0.001),年龄间比较差异无显著性(P>0.05)。结论危重症婴幼儿呼吸道管理中吸引负压安全范围为12.5~17.5kPa,负压吸引的大小与病情有关,与年龄无明显关系。当痰液黏稠时,需通过呼吸道的温湿化稀释痰液和借助拍背振动等物理方法帮助有效清除呼吸道分泌物。
Objective To investigate the appropriate suction negative pressure of suctioning sputum in pediatric critical respiratory tract management. Methods 41 cases of critically ill infants and young children with PICU who did not expect spontaneous sputum were selected as the study objects. Suction negative pressure preset value of 12.5kPa (1 kPa = 7.5mmHg), when the viscous mucus can not be aspirated to 2.5kPa as a unit of negative pressure to gradually increase the suction principle, suction suction negative pressure regulation, record sputum Suck out the situation and whether the bloody sputum. Results (1) 355 cases of effective suction, different suction suction negative respiratory tract mucosal injury bleeding was significantly different (P <0.001), negative pressure in the 12.5 ~ 17.5kPa is safe; (2) 355 cases effective to attract (P <0.001). There was no significant difference between the two groups in age (P> 0.05). Conclusions The safe range of negative suction in respiratory tract management of critically ill infants and young children is 12.5 ~ 17.5kPa. The size of vacuum suction is related to the condition and has no significant relationship with age. When the sputum is viscous, it is necessary to physically remove the respiratory secretions by diluting the sputum with the warmth and dampness of the respiratory tract and by physical means such as beat-back vibration.