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相關文獻
- 比較傳統式抽痰管與密閉式抽痰套管對神經外科重症病患呼吸困難、氧合程度及呼吸器使用相關肺炎感染之影響
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題 名 | 比較傳統式抽痰管與密閉式抽痰套管對神經外科重症病患呼吸困難、氧合程度及呼吸器使用相關肺炎感染之影響=Comparing the Effects of Using an Open VS. Closed Suction Set on Dyspnea, Oxygenation and the Incidence of Ventilator-Associated Penumonia in Critical Meurosurgical Patients |
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作 者 | 張玲華; 王玉君; 張秉宜; 柯如娟; 廖珍娟; |
書刊名 | 中華民國重症醫學雜誌 |
卷 期 | 7:1 民94 |
頁 次 | 頁1-10 |
分類號 | 415.415 |
關鍵詞 | 密閉式抽痰套管; 呼吸困難; 氧合程度; 呼吸器使用相關肺炎; Closed suction set; Dyspena; Oxygenation; Ventilator-assoicated penumonia; |
語 文 | 中文(Chinese) |
中文摘要 | 本研究為描述性研究,目的在比較密閉式抽痰套管與傳統式抽痰管對神經外科重症病患抽痰時呼吸困難、氧合程度及院內肺炎感染的影響。研究之單位為某醫學中心神經外科加護病房,研究採方便取樣,結果為:(一)傳統式抽痰管組34位病患,密閉式抽痰套管組49位病患,二組病患均置放有動脈導管、氣管內管且合併呼吸器使用、並執行氣管抽吸之侵入性處置,此外二組病患之疾病嚴重度與臨床藥物使用(如:H2抑制劑、制酸劑、抗生素及類固醇等)無統計學上差異;(二)傳統式抽痰管組病患因抽痰產生之呼吸困難程度較密閉式抽痰套管組高,前者抽痰後之吐氣潮氣量較抽痰前明顯降低且病患呼吸輔助肌使用情形明顯,前者所致之呼吸困難持續時間亦較長(P值<0.05);(三)氣管抽吸會導致二組病患心跳速率及血壓升高(P值<0.05或P值<0.005),但密閉式抽痰套管組病患卻能於抽痰後30秒內心跳速率回後平常值。至於脈衝式血氧飽和度數值(SpO2)二組病患抽痰前、後均無顯著差異;(四)密閉式抽痰套管的使用並無法有效降低病患呼吸使用相關肺炎的發生,且其病患呼吸道分泌液清除效果亦較傳統式抽痰管組為差(P值<0.005)。綜合上述結果可得知密閉式抽痰套管所造成的生理參數干擾較低,是一個有效且低合併症的氣管抽吸方法。 |
英文摘要 | The object of this study was to compare the clinical effects of a closed-suction catheter system and a conventional open-suction system on critically ill neurosurgical patients. The study was descriptive and comparative, with dyspnea, oxygenation, and incidence of ventilator-associated pneumonia as its variables. 83 patients were selected by convenience sampling and split into two groups, 49 in the closed-suction system group, and 34 in the open-suction group. There were no significant differences between the two groups in terms of severity of disease, age, or medication regimens (e.g. antacids, H2 antagonists, antibiotics, steroid). Results indicated that, firstly, patients using the open-suction system experienced longer and more severe dyspnea (P<.05), and had significantly decreased expiratory tidal volume and increased use of accessory muscles. Secondly, both groups of patients experienced tachycardia (p<.05) and hypertension (p<.005) after suction, although patients from the closed-suction system group returned to a normal heart rate within 30 seconds. There were no significant differences in the SpO2 of the two groups. Thirdly, use of the closed- suction catheter system did not significantly affect incidence of ventilator-associated pneumonia (though the closed0suction system performed less effectively than the open-suction system at airway clearance). The use of close suction se caused fewer physiologic disturbances. Closed suctioning with fewer suction-induced complications appears to be an effective method of endotracheal suctioning. |