摘要
目的 观察呼吸机管路低位摆放联合口鼻腔冲洗干预在肺炎机械通气中应用效果。方法 选取2019年1月至2022年5月我院收治的需机械通气的肺炎患者60例,采用简单随机法分为正常组和观察组各30例。正常组机械通气中采用口鼻腔冲洗干预,观察组机械通气中采用呼吸机管路低位摆放联合口鼻腔冲洗干预。比较两组患者有创通气时间、ICU住院时间及误拔管、呼吸机相关性肺炎(VAP)、28 d病死发生率,检测两组干预前及干预3、7 d降钙素原(PCT)、白细胞计数(WBC)等炎症因子的变化。结果 观察组有创通气时间、ICU住院时间明显短于正常组,冷凝液倒流和VAP发生率明显低于正常组(P<0.05);两组28 d病死率、累计误拔管发生率、临床总有效率比较,差异无统计学意义(P>0.05);干预3、7 d后两组PCT、WBC、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)明显较干预前下降,且观察组炎症因子指标低于正常组(P<0.05)。结论 呼吸机管路低位摆放联合口鼻腔冲洗干预可降低肺炎机械通气中冷凝液倒流发生率,缩短病程,降低VAP的发生。
Objective To observe the effect of low placement of ventilator pipe lines combined with oral and nasal irrigation intervention in mechanical ventilation of pneumonia.Methods From January 2019 to May 2022, 60 pneumonia patients needed mechanical ventilation were selected. The patients were divided into a normal group and an observation group by simple random method, 30 in each group. The normal group was treated with oral and nasal irrigation intervention in mechanical ventilation. The observation group was also treated with oral and nasal irrigation intervention in mechanical ventilation but the ventilator pipelines were placed at a low position. The invasive ventilation time, ICU hospital stay, and the incidence of accidental extubation, ventilator-associated pneumonia(VAP), and 28-day mortality were compared between the two groups. Changes in inflammatory factors such as procalcitonin(PCT) and white blood cell count(WBC) were detected before and during the intervention in the two groups.Results The duration of invasive ventilation and ICU hospital stay in the observation group were significant shorter than the normal group, and the incidence of condensate reflux and VAP was significantly lower in the observation group than those of the normal group(P<0.05). There were no significant differences in mortality rate, cumulative accidental extubation rate and clinical total effective rate of 28 days between the two groups(P>0.05). After 3 and 7 days of intervention, PCT, WBC, tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) were decreased significantly when compared with before intervention, and the inflammatory factor indexes in the observation group was lower than those in the normal group(P<0.05).Conclusions Low placement of ventilator pipe lines combined with oral and nasal irrigation interventions can reduce the incidence of reflux of condensate in mechanical ventilation of pneumonia, shorten the course of the disease, and reduce the occurrence of VAP.
作者
张红梅
陈金亮
桑圣梅
刘瑞红
周芹
范雅丽
ZHANG Hong-mei;CHEN Jin-liang;SANG Sheng-mei;LIU Rui-hong;ZHOU Qin;FAN Ya-li(Department of Respiratory Medicine,The Second Affiliated Hospital of Nantong University,Nantong 226001,China)
出处
《实用医院临床杂志》
2022年第6期18-21,共4页
Practical Journal of Clinical Medicine
基金
江苏省南通市科技项目(编号:XG202001-4)
江苏省科技计划项目(编号:SKB2019021042)。
关键词
呼吸机管路低位摆放
口鼻腔冲洗
肺炎
机械通气
呼吸机相关性肺炎
Ventilator pipeline low position
Oral and nasal irrigation
Pneumonia
Mechanical ventilation
Ventilator-associated pneumonia
