气流冲击法联合间断声门下吸引预防气管插管患者呼吸机相关肺炎的应用效果研究

发布时间：2018-02-09 03:40

本文关键词： 气流冲击法气囊上滞留物间断声门下吸引呼吸机相关性肺炎　出处：《中华医院感染学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的观察气流冲击法清除气囊上滞留物联合间断声门下吸引在气管插管患者中的应用效果。方法选择2014年12月-2016年11月62例在重症医学科治疗的经口气管插管行机械通气的患者,随机分为对照组和试验组,对照组30例患者采用间断声门下吸引,试验组32例患者采用气流冲击法联合间断声门下吸引,比较两组患者每日声门下滞留物总吸引量、呼吸机相关肺炎(VAP)发生率、机械通气时间及ICU住院时间,并对气道分泌物进行目标性监测及病原学检查。结果试验组的机械通气时间为(10±5)d、入住ICU时间为(9.73±5.12)d、VAP的发生率为12.5%,对照组则分别为(15±7)d、(15.64±4.56)d、20.21%,两组比较差异均有统计学意义(P0.05);10例VAP患者痰液标本中共检出病原菌31株,以革兰阴性菌为主,占96.77%。结论气流冲击法清除气囊上滞留物联合间断声门下吸引能够更为有效地将聚积在气管插管气囊上方的声门下分泌物清除干净,从而降低VAP的发生率,缩短患者的机械通气时间和ICU住院时间。
[Abstract]:Objective to observe the effect of airflow impact method in removing air bag retention and intermittent subglottic suction in patients with tracheal intubation. Methods 62 patients treated in intensive care department from December 2014 to November 2016 were treated with oral tracheal intubation from December 2014 to November 2016. Patients with mechanical ventilation, The patients in the control group were randomly divided into control group and experimental group. 30 patients in the control group were treated with subglottic aspiration, 32 patients in the test group were treated with airflow shock combined with subglottic aspiration, and the total amount of subglottic retention was compared between the two groups. The incidence of ventilator-associated pneumonia (VAP), the duration of mechanical ventilation and the hospitalization time of ICU. Results the time of mechanical ventilation was 10 卤5 days, the duration of ICU was 9.73 卤5.12 d and the incidence of ICU was 12.5in the experimental group, and 15.64 卤4.56 d in the control group. The difference between the two groups was statistically significant (P 0.05). A total of 31 strains of pathogenic bacteria were detected in sputum of patients with VAP. Conclusion removal of air bag retention by airflow impact combined with intermittent subglottic suction can effectively remove subglottic secretions accumulated above tracheal intubation sac, thus reducing the incidence of VAP. The duration of mechanical ventilation and the hospitalization time of ICU were shortened.
【作者单位】：江苏大学教学医院南通大学教学医院宜兴市第二人民医院重症医学科;江苏大学教学医院南通大学教学医院宜兴市第二人民医院普外科;
【基金】：江苏大学医学临床科技发展基金资助项目(JLY20140080) 宜兴市民生科技示范工程建设推进计划基金资助项目(2014-20)
【分类号】：R459.7;R563.1

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