呼吸过滤器在无创机械通气中的应用研究

发布时间：2018-09-17 07:21

【摘要】：目的:探讨在无创机械通气患者是否有使用呼吸过滤器(breathing filter,BF)的必要性,为临床的合理应用提供参考依据。方法:(1)选取进行无创机械通气的30例患者,在呼吸过滤器分别使用24h、48h后,对过滤膜的两侧分别采样并进行细菌检测以评价滤菌效果;(2)根据滤菌效果研究结果,将进行无创机械通气的450例患者随机分为三组:A组(使用呼吸过滤器且每24h更换)、B组(未使用呼吸过滤器)、C组(使用呼吸过滤器且每48h更换),比较三组患者ICU住院时间、无创机械通气时间、医院获得性肺炎(hospital acquired pneumonia,HAP)感染率、疾病转归等指标。结果:(1)呼吸过滤器使用24h后滤菌率为100%,使用48h后滤菌率为92.85%;(2)对比使用24h、48h后的呼吸过滤器过滤膜两侧即呼吸机侧与患者侧的细菌检测结果差异无统计学意义(P0.05);(3)三组患者在ICU住院时间、无创机械通气时间、HAP感染率以及疾病转归差异无统计学意义(P值分别为0.1134、0.5988、0.8580、0.0796)。结论:(1)呼吸过滤器在无创机械通气中使用48h后亦具有良好的细菌滤过功能;(2)在无创机械通气患者中未使用呼吸过滤器,其ICU住院时间、无创机械通气时间、HAP感染率并未增加,患者预后也未受,却增加了患者的经济成本,建议在无创机械通气中可以不使用呼吸过滤器。
[Abstract]:Objective: to explore the necessity of using breathing filter (breathing filter,BF) in patients with non-invasive mechanical ventilation. Methods: (1) A total of 30 patients undergoing non-invasive mechanical ventilation were selected. After 24 h or 48 hours of use of the filter respectively, the two sides of the membrane were sampled and the bacteria were detected to evaluate the effect of the filter. (2) according to the results of the study, 450 patients undergoing non-invasive mechanical ventilation were randomly divided into three groups: group A (using breathing filter and changing every 24 hours) and group B (without breathing filter) and group C (using breathing filter and changing every 48 hours). The hospitalization time of ICU was compared among the three groups. Non-invasive mechanical ventilation time, hospital acquired pneumonia (hospital acquired pneumonia,HAP) infection rate, disease outcome and other indicators. Results: (1) the bacteriological rate of respiratory filter was 100 after 24 h and 92.85 after 48h; (2) there was no significant difference between the two sides of the filter membrane after 24 h and the patient side (P0.05); (3). Length of stay in ICU, There was no significant difference in HAP infection rate and disease outcome (P = 0.11340.5988U 0.8580,0.0796). Conclusion: (1) the respiratory filter also had good bacterial filtration function after 48 hours of non-invasive mechanical ventilation, (2) the ICU hospitalization time and the time of non-invasive mechanical ventilation did not increase in the patients with non-invasive mechanical ventilation. The patient's prognosis is not affected, but increases the patient's economic cost, the recommendation may not use the breath filter in the noninvasive mechanical ventilation.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R472

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