首页|改良正压拔管技术在ICU经口气管插管拔除时的效果

改良正压拔管技术在ICU经口气管插管拔除时的效果

Effect of modified positive pressure extubation technique in the removal of oral tracheal intubation in ICU

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 维普
  • 万方数据
目的 探讨改良正压拔管技术在ICU经口气管插管拔除时的临床效果.方法 选取2022年1月至2023年4月岑溪市人民医院收治的124例ICU患者作为研究对象,按照掷硬币法将其分为试验组(63例)与对照组(61例),试验组采用改良正压拔管技术,对照组采用传统负压拔管技术.比较两组患者拔管前和拔管后1、15 min的生命体征(包括心率、血压、呼吸、血氧饱和度)以及拔管后的并发症发生率.结果 两组患者拔管后1 min时的收缩压均高于本组拔管前时;试验组拔管后15 min时的平均动脉压低于本组拔管前和拔管后1 min时;试验组拔管后15 min时的呼吸慢于本组拔管后1 min时,对照组拔管后1 min时的呼吸快于本组拔管前时;两组患者拔管后1 min时的血氧饱和度均低于本组拔管前时,差异有统计学意义(P＜0.05).试验组拔管后15 min的高血压、心动过速、氧饱和度下降、呼吸急促、严重咳嗽、咽喉疼痛、上气道痉挛的发生率均低于对照组,差异有统计学意义(P＜0.05);两组患者的拔管失败发生率比较,差异无统计学意义(P＞0.05).结论 两种技术在ICU经口气管插管拔除后1 min均会引起收缩压升高、血氧饱和度降低,但改良正压拔管技术所带来的并发症发生率较低,值得临床应用和推广.
Objective To investigate the clinical effect of modified positive pressure extubation technique in the removal of oral tracheal intubation in ICU.Methods A total of 124 ICU patients admitted to the People's Hospital of Cenxi City from January 2022 to April 2023 were selected as the research objects,and they were divided into experimental group(63 cases)and control group(61 cases)according to coin toss method.The experimental group adopted improved positive pressure ex-tubation technology,and the control group adopted traditional negative pressure extubation technology.The vital signs(in-cluding heart rate,blood pressure,respiration,blood oxygen saturation)before extubation,1 min and 15 min after extubation,and the incidence of complications after extubation were compared between the two groups.Results The systolic blood pres-sure of the two groups at 1 min after extubation were higher than those before extubation,the mean arterial pressure of the experimental group at 15 min after extubation was lower than that before extubation and 1 min after extubation,the breathing of the experimental group at 15 min after extubation was slower than that at 1 min after extubation,while the breathing of the control group at 1 min after extubation was faster than that before extubation,the blood oxygen saturation of the two groups at 1 min after extubation were lower than those before extubation,and the differences were statistically significant(P＜0.05).The incidence of hypertension,tachycardia,oxygen saturation decline,shortness of breath,severe cough,sore throat,and upper airway spasm in the experimental group 15 min after extubation were lower than those in the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of extu-bation failure between the two groups(P＞0.05).Conclusion Both of the two techniques can cause the increase of systolic blood pressure and the decrease of blood oxygen saturation at 1 min after the removal of oral tracheal intubation in ICU.However,the incidence of complications caused by the modified positive pressure extubation technique is lower,which is worthy of clinical application and promotion.

Improved positive pressure extubation tech-nologyTraditional negative pressure extubation tech-nologyExtubation complicationsBreath tube intubation

赵茹茹、黄德斌

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广西医科大学第一附属医院重症医学科二病区,广西南宁 530021

改良正压拔管技术 传统负压拔管技术 拔管并发症 经口气管插管

广西壮族自治区梧州市科技计划广西壮族自治区高等学校中青年教师科研基础能力提升项目

2021021062023KY0131

2024

中国当代医药
中国保健协会 当代创新（北京）医药科学研究院

中国当代医药

影响因子：1.215
ISSN：1674-4721
年,卷(期)：2024.31(1)
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