声门下积液清除方法对呼吸机相关性肺炎的影响研究

发布时间：2018-07-09 12:56

  本文选题：机械通气 + 呼吸机相关肺炎　； 参考：《中华医院感染学杂志》2014年20期

【摘要】：目的探讨不同声门下积液清除方法对下呼吸道细菌数和呼吸机相关性肺炎(VAP)发生率、机械通气(MV)时间、ICU入住时间、病死率的影响,为临床预防VAP提供参考。方法对2011年1-12月入住综合ICU行机械通气48h的57例患者进行研究,按随机数字表法分为A组30例、B组27例,A组在常规气道护理的基础上进行声门下冲洗;B组在常规气道护理的基础上进行声门下联合口咽部冲洗,分别于MV48h、4、7d收集气囊滞留物和下呼吸道分泌物进行细菌培养,观察MV患者VAP发生率、MV时间、ICU入住时间、病死率,采用SPSS17.0软件进行统计分析。结果 MV5dVAP发生率A组为46.67%、B为14.82%,差异有统计学意义(P0.05),MV≥5dVAP发生率A组为70.00%、B为51.85%,差异无统计学意义;两组患者MV时间、ICU入住时间、病死率比较差异无统计学意义,但发生与未发生VAP患者的MV时间、ICU入住时间比较,差异有统计学意义(P0.05);发生与未发生VAP患者的病死率比较,差异无统计学意义。结论声门下联合口咽部冲洗比单纯声门下冲洗能更有效地降低早发性VAP的发生率;VAP的发生可使重症患者的MV时间、ICU入住时间明显延长。
[Abstract]:Objective to investigate the effects of different subglottic effusion clearance methods on the bacterial count of lower respiratory tract, the incidence of ventilator-associated pneumonia (VAP), the time of mechanical ventilation (MV) and the time of ICU admission, and the mortality of ICU, so as to provide a reference for clinical prevention of VAP. Methods A total of 57 patients admitted to ICU for 48 hours from January to December 2011 were studied. According to the method of random digital table, group A (n = 30) and group B (n = 27) were divided into group A (n = 30) and group A (n = 27) undergoing subglottic irrigation on the basis of routine airway nursing and group B (n = 27) undergoing subglottic combined oropharynx washing on the basis of routine airway nursing. The bacterial culture of air bag retention and lower respiratory tract secretion were collected for 7 days after MV 48h. The incidence of VAP in MV patients and the time of ICU stay and mortality were observed. SPSS 17.0 software was used for statistical analysis. Results the incidence rate of MV 5d VAP in group A was 46.67 and 14.82B, the difference was statistically significant (P0.05) the incidence rate of MV 鈮，

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