摘要
目的探讨应用可冲洗式气管套管行气囊上分泌物吸引对呼吸机相关性肺炎(VAP)及细菌学的影响。方法将ICU82例气管切开行机械通气(MV)的患者随机分为两组:A组(普通气管套管组)38例,B组(冲洗式气管套管组)44例;气管切开后每天收集咽拭子、气囊上分泌物、气管套管内呼吸道分泌物行细菌学检查,并记录机械通气天数及VAP发生情况。结果 4d两组VAP发生率差异无统计学意义,第4～10天B组(22.7%)VAP发生率明显低于A组(52.6%),两组VAP患者下呼吸道分泌物细菌培养以铜绿假单胞菌,肺炎克雷伯菌、鲍氏不动杆菌、大肠埃希菌、金黄色葡萄球菌为主,铜绿假单胞菌、大肠埃希菌对同种药物的耐药率B组明显低于A组(P<0.05)。结论采用可冲洗式气管套管行气囊上分泌物吸引可降低VAP的发生率并减少细菌耐药。
OBJECTIVE To investigate the effect of subglottic drainage with open incision on ventilator associated pneumonia（VAP）and bacteriology.METHODS Eighty two patients with open incision and mechanical ventilation in ICU were randomly divided into two groups：A group（general tracheal tube sets;n 38）,B group（flushing tracheal tube sets;n=44）.The sub pharyngeal swab,secretion on the balloon and secretion in the respiratory were bacteriologically examined after open incision.RESULTS The incidence rates of VAP during four days were not different between A group and B group（P0.05）,The incidence of VAP of B group form（4-10 days）were significantly lower compered with A group（A group：20（52.6）;B group：10（22.7）P0.01）;Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii,Escherichia coli,Staphylococcus aureus were conmon in the germiculture of secretion in the lower respiratory tract in the two groups.The drug resistance rate of B group were lower compered with A group Significantly from P.aeruginosa and E.coli（P0.05）.CONCLUSION The incidence rate of VAP and drug resistance rate are reduced by the subglottic drainage on the balloon of flushing tracheal tube sets.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第20期3134-3136,共3页
Chinese Journal of Nosocomiology
关键词
吸入性肺炎
气囊上分泌物吸引
呼吸机相关性肺炎
细菌
耐药
机械通气
Aspiration pneumonia
Subglottic drainage on the balloon
Ventilator associated pneumonia
Bacteria
Drug resistance
Mechanical ventilation
