CAJ | 학술논문

目的观察人工鼻联合密闭式吸痰对建立人工气道机械通气患者湿化效果的影响.方法将入住ICU机械通气超过48 h的患者114例按随机数字表法分为观察组(人工鼻联合密闭式吸痰组)59例和对照组(开放性吸痰管联合加温加湿器组)55例,对两组人工气道湿化的效果、应用人工气道时间、应用机械通气时间、呼吸机相关性肺炎(VAP)的发生率、住ICU的时间、住院病死率等方面进行比较.结果观察组患者痰液湿化效果好的病例多于对照组,导管痰痂病例少于对照组;应用人工气道时间两组病例比较无差异;观察组在应用机械通气时间和住ICU的时间上均少于对照组,观察组VAP发生率低于对照组;病死率两组病例比较无差异;观察组无湿化意外出现,对照组发生呛水8例.结论机械通气患者使用人工鼻联合密闭式吸痰进行气道管理,能够满足加热加湿吸入气体的要求,有利于改善气道湿化效果,且能降低VAP发生率,缩短机械通气时间.
목적 관찰인공비연합밀폐식흡담대건립인공기도궤계통기환자습화효과적영향.방법 장입주ICU궤계통기초과48 h적환자114례안수궤수자표법분위관찰조(인공비연합밀폐식흡담조)59례화대조조(개방성흡담관연합가온가습기조)55례,대량조인공기도습화적효과、응용인공기도시간、응용궤계통기시간、호흡궤상관성폐염(VAP)적발생솔、주ICU적시간、주원병사솔등방면진행비교.결과 관찰조환자담액습화효과호적병례다우대조조,도관담가병례소우대조조;응용인공기도시간량조병례비교무차이;관찰조재응용궤계통기시간화주ICU적시간상균소우대조조,관찰조VAP발생솔저우대조조;병사솔량조병례비교무차이;관찰조무습화의외출현,대조조발생창수8례.결론 궤계통기환자사용인공비연합밀폐식흡담진행기도관리,능구만족가열가습흡입기체적요구,유리우개선기도습화효과,차능강저VAP발생솔,축단궤계통기시간.
Objective To explore humidifying effects for artificial airway of mechanically ventilated patients by heat/moisture exchanger(HME) combined closed endotracheal suctioning(CS).Methods A total of 114 patients who had mechanical ventilation for at least 48h were randomly divided into two groups with 59 cases in experimental grooup and 55 cases in control group.HME combined CS were used in the experimental group,heated humidifier combined open endotracheal suctioning were used in the control group.The effect of humidification, the reserved time of artificial airway,the time on mechanical ventilation, the time of stay in ICU, the incidence of ventilator-associated pneumonia(VAP) and the mortality rate between the two groups were compared.Results Significant differences were found in the effect of humidification between the experimental group and the control group,more cases found insufficiency of humidification or excessive humidification and airway spasm in the control group, however,less time on mechanical ventilation and stay in ICU in the experimental group.The incidence of VAP in the control group was significantly higher than that in the experimental group.There were no significant differences existed in the reserved time of artificial airway and the mortality rate between the two groups.There were no accident of humidification occurred in the experimental group,while 8 cases complicated with choking with water in the control group.Condusion HME combined CS,used in mechanically ventilated patients ,could help to improve the effects of airway humidification and reduce the incidence of VAP,also shorten the duration of mechanical ventilation.