口咽通气管吸痰在脑梗塞舌后坠合并肺部感染患者的应用效果

[摘要] 目的 研究对脑梗塞舌后坠合并肺部感染患者使用口咽通气管内吸痰的临床效果。方法 于该院方便选取112例脑梗舌后坠患者，时间在2018年11月—2019年11月，使用抽签法进行分组，分为两组各56例，给予患者可调负压吸引管吸痰为参照组，在参照组基础上给予口咽通气管吸痰为研究组，对两组临床效果进行分析。结果 分析两组治疗前后PaO2、PaCO2、PH指标，治疗前，两组差异无统计学意义（P>0.05），治疗后，研究组PaO2、pH值均高于参照组，PaCO2低于参照组（P<0.05）;研究组痰鸣音消失、呼吸困难消失、住院总时间分别为（4.15±1.21）、（1.69±0.58）、（15.28±4.19）d，参照组分别为（6.67±2.10）、（2.71±1.77）、（18.99±3.54）d，研究组均短于对照组，排痰量（42.36±3.58）mL/d多于参照组（27.16±3.49）mL/d，差异有统计学意义（t=7.781、4.098、5.061、22.751，P<0.05）;分析两组治疗前后生活质量评分，治疗前两组差异无统计学意义（P>0.05），治疗后，研究组均高于参照组（P<0.05）;对比两组治疗总有效率，研究高于参照组（P>0.05）。结论 对脑梗塞舌后坠患者使用口咽通气管联合可調负压吸引管吸痰可以明显改善其临床症状，缓解患者各项血气分析指标，促进治疗进展，改善预后，对脑梗塞舌后坠患者具有重要意义，值得临床应用并推广。

[关键词] 肺部疾病;可调负压;口咽通气管;脑梗塞;吸引管;舌后坠

[中图分类号] R563          [文献标识码] A          [文章编号] 1674-0742（2020）06（c）-0142-03

Application Effect of Oropharyngeal Sputum Aspiration in Patients with Cerebral Infarction Falling behind Tongue and Pulmonary Infection

YANG Lu-hui

Emergency Department， Jiexi County People's Hospital， Jieyang， Guangdong Province， 515400 China

[Abstract] Objective To study the clinical effect of using oropharyngeal sputum suction in patients with cerebral infarction and tongue drop combined with pulmonary infection. Methods 112 patients with cerebral infarction and posterior tongue drop were convenient selected selected in the hospital. The time was selected from November 2018 to November 2019. They were divided into two groups using a lottery method， and 56 patients were divided into two groups. The patients were given adjustable negative pressure suction tubes. As the reference group， the oropharyngeal airway suctioning sputum was given as the research group based on the reference group， and the clinical effects of the two groups were analyzed. Results The PaO2， PaCO2， pH indexes of the two groups before and after treatment were analyzed. Before treatment， there was no significant difference between the two groups （P>0.05）. After treatment， the PaO2 and pH values of the study group were higher than the reference group， and PaCO2 was lower than the reference group（P<0.05）; the sputum sound disappeared， the dyspnea disappeared in the study group， the total length of hospitalization was （4.15±1.21）d，（1.69±0.58）d，（15.28±4.19）d， and the reference group was （6.67±2.10）d，（2.71±1.77）d，（18.99±3.54）d， the study group was shorter than the control group， the sputum output （42.36±3.58） mL/d was more than the reference group （27.16±3.49）mL/d， the difference is obvious （t=7.781，4.098， 5.061，22.751， P<0.05）; analysis of the quality of life scores of the two groups before and after treatment， no significant difference between the two groups before treatment（P>0.05）， after treatment， the study group was higher than the reference group （P<0.05）; comparing the two groups， the total treatment efficiency was higher than the reference group （P>0.05）. Conclusion The use of oropharyngeal ventilator combined with adjustable negative pressure suction tube sputum suction for patients with cerebral infarction and tongue fall can significantly improve its clinical symptoms， relieve patients' various blood gas analysis indicators， promote treatment progress， improve prognosis， and treat patients with cerebral infarction after tongue fall， with important significance and which is worthy of clinical application and promotion.

[Key words] Lung disease; Adjustable negative pressure; Oropharyngeal ventilator; Cerebral infarction; Suction tube; Tongue fall

脑梗塞又称为缺血性脑卒中（cerebral ischemic stroke），是临床常见疾病，脑梗塞是一组脑部血液供应不足，缺血、缺氧导致的局限性脑组织缺血性坏死或软化。头痛、头晕、恶心呕吐等均是该病的主要临床表现。脑梗塞患者因脑部病变，导致大脑皮层以及皮层下网状结构的高度抑制，致使咽部肌群完全或不完全麻痹，引发舌部以及喉部肌张力下降，致使舌后坠，舌体后坠会对通气功能造成影响，加重脑部缺氧，对患者生命安全造成严重威胁[1]。现今，随着我国人口数的不断上升，生活方式以及饮食习惯等不断改变，脑梗塞发病率也随之上升，对患者生活以及工作带来严重影响[2]。及时……