封闭和开放吸痰方法对ICU机械通气患者疼痛和躁动影响的比较(1)
摘 要：目的 比较封闭和开放两种吸痰方法对ICU机械通气患者疼痛和躁动的影响。方法 研究对象为2017年5月～12月在首都医科大学大兴教学医院ICU接受机械通气治疗的60例患者。本研究采取单中心、随机对照试验设计的临床研究，采用随机数字表将纳入的患者分到封閉吸痰组和开放吸痰组，每组30例。封闭吸痰为试验组，开放吸痰为对照组。在吸痰操作之前、过程中、结束后即刻、结束后5 min、结束后20 min分别进行行为疼痛评分和Richmond镇静躁动评分。结果 两组的BPS和RASS评分在吸痰操作后均有增高，两种吸痰方法所引起的疼痛和躁动水平增加的幅度基本相同，差异无统计学意义(P>0.05)。结论 上述两种吸痰方法对ICU机械通气患者疼痛和躁动的影响无显著差异，可能需要更大样本量的研究来证明。
关键词：吸痰；机械通气；疼痛；躁动
中图分类号：R472 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.15.029
, 百拇医药
文章编号：1006-1959(2018)15-0094-03
Comparison of Effects of Closed and Open Suction Methods on Pain and Agitation in ICU Patients with Mechanical Ventilation
CHANG Hong-xia，WANG Zhu-heng，GUO Qing-hua，ZHOU Guan-hua
(Department of Critical Care Medicine，Daxing Teaching Hospital，Capital Medical University，Beijing 102600，China)
Abstract：Objective To compare the effects of closed and open suction methods on pain and agitation in ICU patients with mechanical ventilation.Methods The study subjects were 60 patients who underwent mechanical ventilation at the ICU of Daxing Teaching Hospital of Capital Medical University from May to December 2017.This study used a single-center，randomized controlled trial design clinical study，using a random number table to include patients in the closed sucking group and open sucking= group，30 patients in each group.The closed sucking was the experimental group，and the open sucking was the control group. Behavioral pain scores and Richmond sedation scores were performed before，during，and immediately after the end of the inhalation procedure，5 min after the end，and 20 min after the end.Results The BPS and RASS scores of the two groups increased after sucking operation.The increase of pain and agitation caused by the two methods was basically the same，but the difference was not statistically significant(P>0.05).Conclusion There is no significant difference in the effects of the above two methods of suction on pain and agitation in ICU patients，which may require a larger sample size study.
, 百拇医药
Key words：Suction；Mechanical ventilation；Pain；Agitation
气管内吸痰是ICU中机械通气患者治疗过程中常见的护理操作。该操作过程不可避免的会引起患者的不适及精神紧张，而且可能导致患者呼吸频率增加、低氧血症、增加院内感染、心律失常、出血等不良事件发生的机率。吸痰操作本身和相关不良事件均会引起患者的疼痛和躁动[1，2]。对于机械通气患者在接受吸痰操作时由于吸痰管插入气管的刺激通常会感到痛苦和恐惧，并且对于自主呼吸困难的部分患者由于吸痰操作时呼吸辅助的中断还会有窒息的感觉[3-5]。目前临床实际工作中普遍使用的气管内吸痰方法有两种：开放式吸痰(the open suction system，OSS)和封闭式吸痰(the closed suction system，CSS)。因此，在对ICU机械通气患者吸痰过程中如何降低和减少患者的疼痛和躁动就成为临床实际工作中非常重要的问题。本研究对两种吸痰方法对ICU机械通气患者疼痛和躁动的影响，现分析如下。
1资料与方法, 百拇医药(常红霞 王助衡 郭清华 周冠华)
关键词：吸痰；机械通气；疼痛；躁动
中图分类号：R472 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.15.029
, 百拇医药
文章编号：1006-1959(2018)15-0094-03
Comparison of Effects of Closed and Open Suction Methods on Pain and Agitation in ICU Patients with Mechanical Ventilation
CHANG Hong-xia，WANG Zhu-heng，GUO Qing-hua，ZHOU Guan-hua
(Department of Critical Care Medicine，Daxing Teaching Hospital，Capital Medical University，Beijing 102600，China)
Abstract：Objective To compare the effects of closed and open suction methods on pain and agitation in ICU patients with mechanical ventilation.Methods The study subjects were 60 patients who underwent mechanical ventilation at the ICU of Daxing Teaching Hospital of Capital Medical University from May to December 2017.This study used a single-center，randomized controlled trial design clinical study，using a random number table to include patients in the closed sucking group and open sucking= group，30 patients in each group.The closed sucking was the experimental group，and the open sucking was the control group. Behavioral pain scores and Richmond sedation scores were performed before，during，and immediately after the end of the inhalation procedure，5 min after the end，and 20 min after the end.Results The BPS and RASS scores of the two groups increased after sucking operation.The increase of pain and agitation caused by the two methods was basically the same，but the difference was not statistically significant(P>0.05).Conclusion There is no significant difference in the effects of the above two methods of suction on pain and agitation in ICU patients，which may require a larger sample size study.
, 百拇医药
Key words：Suction；Mechanical ventilation；Pain；Agitation
气管内吸痰是ICU中机械通气患者治疗过程中常见的护理操作。该操作过程不可避免的会引起患者的不适及精神紧张，而且可能导致患者呼吸频率增加、低氧血症、增加院内感染、心律失常、出血等不良事件发生的机率。吸痰操作本身和相关不良事件均会引起患者的疼痛和躁动[1，2]。对于机械通气患者在接受吸痰操作时由于吸痰管插入气管的刺激通常会感到痛苦和恐惧，并且对于自主呼吸困难的部分患者由于吸痰操作时呼吸辅助的中断还会有窒息的感觉[3-5]。目前临床实际工作中普遍使用的气管内吸痰方法有两种：开放式吸痰(the open suction system，OSS)和封闭式吸痰(the closed suction system，CSS)。因此，在对ICU机械通气患者吸痰过程中如何降低和减少患者的疼痛和躁动就成为临床实际工作中非常重要的问题。本研究对两种吸痰方法对ICU机械通气患者疼痛和躁动的影响，现分析如下。
1资料与方法, 百拇医药(常红霞 王助衡 郭清华 周冠华)