摘要
目的:分析密闭式双加热丝呼吸机湿化模式改善呼吸机相关性肺炎(VAP)的临床效果。方法:选取120例行机械通气患者,按照随机数表法将其分为观察组和对照组,每组60例。对照组采用一次性普通型无加热丝的呼吸机管道湿化模式,观察组采用一次性密闭式双加热丝呼吸机管道湿化模式。分析两组患者不同呼吸机呼吸通气时间的血白细胞数和中性粒细胞百分比、呼吸通气28 d的痰液粘稠度、痰痂形成例数、气道痉挛、气道黏膜损伤与气管导管堵管、VAP发生及管道护理指标情况。结果:呼吸通气28 d时观察组患者痰液粘稠度级别优于对照组,其差异有统计学意义(x^2=2.191,P<0.05);两组患者痰痂形成例数、气道痉挛、气道黏膜损伤及气管导管堵管发生率比较,差异有统计学意义(x^2=10.909,x^2=8.571,x^2=4.821,x^2=4.138;P<0.05);两组呼吸通气后7 d、14 d及28 d时VAP发生率比较,差异有统计学意义(x^2=4.183,x^2=4.910,x^2=5.714;P<0.05);两组管道更换数和倾倒冷凝水量比较,差异有统计学意义(t=16.965,t=40.584;P<0.05);两组管道使用时间和呼吸机管道护理时间比较,差异有统计学意义(t=10.149,t=28.704;P<0.05);两组在呼吸通气第1 d、3 d和7 d的血白细胞数比较,差异有统计学意义(x^2=4.019,x^2=4.101, x^2=4.519;P<0.05),中性粒细胞百分比的比较,差异有统计学意义(x^2=8.189,x^2=10.694,x^2=8.626;P<0.05)。结论:一次性密闭式双加热丝呼吸机管道湿化模式能改善机械通气患者的VAP发生率,并改善VAP患者的相关临床指标,具有较高的临床意义。
Objective: To analyze the clinical effect of humidification mode of closed double-heated wire ventilator on improving ventilator-associated pneumonia (VAP). Methods: 120 patients who underwent mechanical ventilation in our hospital were randomly divided into observation group and control group, with 60 cases in each group. The control group adopted tube humidification mode of disposable common type of non-heated wire ventilator, and the observation group adopted tube humidification mode of disposable closed double heating wire ventilator. The number of white blood cells and the percentage of neutrophils in breathing time of different ventilator, the viscosity of sputum, the number of sputum scab, airway spasm, airway mucosal injury and tracheal tube occlusion, the occurrence of VAP and tube maintenance indicators were observed for 28 days after respiratory ventilation of two groups were analyzed. Results: The viscosity level of sputum of observation groups was better than that of control group at 28 days after respiratory ventilation (x2=2.191, P<0.05). The differences of the number of sputum scab, airway spasm, airway mucosal injury and the incidence rate of tracheal tube occlusion between the two groups were significant (x2=10.909, x2=8.571, x2=4.821, x2=4.138, P<0.05). The incidence rates of VAP at 7d, 14d and 28 d after respiratory ventilation between two groups were statistically significant (x2=4.183, x2=4.910, x2=5.714, P<0.05). The differences of the number of tube replacement and volume of dumping condensate between the two groups were statistically significant (t=16.965, t=40.584, P<0.05). And the differences of using time of tube and maintenance time of ventilator tube between the two groups were significant (t=10.149, t=28.704, P<0.05). The differences of white blood cell between the two groups at 1d, 3d and 7d post respiratory ventilation were significant (x2=4.019, x2=4.101, x2=4.519, P<0.05). The difference of the percentage of neutrophils between the two groups were statistically significant (x2=8
作者
李金花
任兴华
LI Jin-hua;REN Xing-hua(Intensive Care Unit, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China.)
出处
《中国医学装备》
2019年第5期81-84,共4页
China Medical Equipment
基金
全军医疗科研重大项目计划(MR1710980)"双加热式密闭式呼吸机湿化管道系统对呼吸机相关性肺炎发生的影响"
关键词
呼吸机相关性肺炎
湿化模式
密闭式双加热丝呼吸机
普通型无加热丝呼吸机
机械通气
Ventilator-associated pneumonia
Humidification mode
Ventilator with closed double-heated wire
Common type of non-heated wire ventilator
Mechanical ventilation
