摘要
目的探讨低流量氧驱雾化吸入对重型颅脑损伤气管切开患者呼气末肺阻抗和生命体征的影响.方法便利选取我院2019年1月—9月47例重型颅脑损伤气管切开非机械通气的患者,2019年1月—4月在院患者为对照组(23例),2019年5月—9月在院患者为试验组(24例)分别予以高流量6~8 L/min和低流量4~6 L/min氧驱雾化吸入.运用电阻抗成像技术监测两组患者雾化过程中呼气末肺阻抗的变化和记录两组雾化前后的心率、经皮血氧饱和度、平均动脉血压的变化,并将两组雾化前后痰液的黏稠度进行比较.结果两组在经皮血氧饱和度和平均动脉血压的差异无统计学意义(P>0.05);低流量组较高流量组雾化前后心率变化更小,差异有统计学意义(P<0.05);低流量组较高流量组痰液黏稠度下降更多,差异有统计学意义(P<0.05);低流量组较高流量组在雾化时10 min和雾化结束后15 min的呼吸末肺阻抗均增加,差异有统计学意义(P<0.05).结论重型颅脑损伤气管切开的患者氧驱雾化吸入时可选择低氧流量(4~6 L/min).
Objective To investigate the effects of low flow oxygen-driven nebulization on end-expiratory impedance and vital signs in patients with severe craniocerebral injury after tracheotomy.Methods We recruited 47 patients with severe craniocerebral injury who underwent tracheotomy and were not mechanically ventilated in our hospital from January 2019 to September 2019.23 patients from January to April 2019 were the control group and were given oxygen driven nebulization with high flow rate of 6~8 L/min.24 patients from May to September 2019 were the experimental group and were given nebulization with low flow rate of 4~6 L/min.Electrical impedance imaging was used to monitor the changes of end-expiratory lung impedance during the process of nebulization and record the changes of heart rate,percutaneous oxygen saturation and mean arterial blood pressure before and after nebulization in the two groups.The sputum viscosity before and after nebulization were compared between the two groups.Results There were no significant differences in oxygen saturation and mean arterial blood pressure between the two groups(P>0.05).The change of heart rate before and after nebulization was less in the lower oxygen flow group than the higher flow group and the difference was statistically significant(P<0.05).The sputum viscosity of the lower flow group decreased more than the higher flow group and the difference was statistically significant(P<0.05).End-expiratory lung impedance at 10 minutes of nebulization and 15 minutes after nebulization increased in the lower flow group and the differences were statistically significant(P<0.05).Conclusion Low oxygen flow rate(4~6 L/min)can be used for oxygen-driven nebulization in patients with severe craniocerebral injury after tracheotomy.
作者
张婷婷
程静娟
眭建
赵薇
陆小良
周录琴
ZHANG Tingting;CHENG Jingjuan;SUI Jian;ZHAO Wei;LU Xiaoliang;ZHOU Luqin(Intensive Care Unit,The Affiliated Suzhou Science&Technology Town Hospital of Nanjing Medical University,Suzhou,215000,China;不详)
出处
《中华急危重症护理杂志》
2020年第2期104-107,共4页
Chinese Journal of Emergency and Critical Care Nursing
关键词
呼气末肺阻抗
雾化吸入
重型颅脑损伤
气管切开
电阻抗成像技术
End-Expiratory Lung Impedance
Nebulization
Severe Craniocerebral Injury
Tracheotomy
Electrical Impedance Tomography
作者简介
通信作者:程静娟,E-mail:chengjingjuan995@163.com;张婷婷:女,本科(硕士在读),护师,E-mail:744649421@qq.com
