中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
8期
939-941
,共3页
肺炎,呼吸机相关性%加热丝%呼吸管路%通气机,负压
肺炎,呼吸機相關性%加熱絲%呼吸管路%通氣機,負壓
폐염,호흡궤상관성%가열사%호흡관로%통기궤,부압
Pneumonia,ventilator-associated%Heating wire%Breath pipeline%Ventilators,negativepressure
目的 探讨含加热丝呼吸管路在预防呼吸机相关性肺炎(VAP)的临床价值.方法 将我院ICU收治的有创机械通气患者完全随机分为对照组(53例),研究组A(54例)和研究组B(53例).对照组呼吸机管路不含加热导丝,研究组A在吸气径路含有加热导丝(单加热丝),研究组B在吸气和呼气径路均含有加热导丝(双加热丝).观察并比较各组患者VAP的发生率、发生时间以及引起VAP的病原菌.结果 研究组A和B患者的早发性VAP发生率[分别为5.6％ (3/54)、3.8％(2/53)]均明显低于对照组[26.4％(14/53)],差异有统计学意义(均P＜0.05).研究组B患者的迟发性VAP发生率[9.4％(5/53)]明显低于对照组和研究组A[分别为22.6％(12/53)、24.1％ (13/54)],组间比较差异有统计学意义(P＜0.05).研究组A和B患者VAP发生时间均较对照组延迟,组间比较差异有统计学意义(P＜0.05)；研究组B患者VAP发生时间晚于研究组A,组间比较差异有统计学意义(P＜0.05).研究组A、B及对照组患者绿脓杆菌感染率分别为7.4％ (4/54)、3.8％ (2/53)及34.0％ (18/53),研究组与对照组比较,差异有统计学意义(P＜0.05).结论 含加热丝呼吸管路较普通管路可以降低早发性VAP的发生率,使发生时间延迟；双加热丝较单加热丝可更为有效的延迟VAP的发生,并且降低迟发性VAP发生率；一次性加热丝呼吸管路可降低绿脓杆菌感染率.
目的 探討含加熱絲呼吸管路在預防呼吸機相關性肺炎(VAP)的臨床價值.方法 將我院ICU收治的有創機械通氣患者完全隨機分為對照組(53例),研究組A(54例)和研究組B(53例).對照組呼吸機管路不含加熱導絲,研究組A在吸氣徑路含有加熱導絲(單加熱絲),研究組B在吸氣和呼氣徑路均含有加熱導絲(雙加熱絲).觀察併比較各組患者VAP的髮生率、髮生時間以及引起VAP的病原菌.結果 研究組A和B患者的早髮性VAP髮生率[分彆為5.6％ (3/54)、3.8％(2/53)]均明顯低于對照組[26.4％(14/53)],差異有統計學意義(均P＜0.05).研究組B患者的遲髮性VAP髮生率[9.4％(5/53)]明顯低于對照組和研究組A[分彆為22.6％(12/53)、24.1％ (13/54)],組間比較差異有統計學意義(P＜0.05).研究組A和B患者VAP髮生時間均較對照組延遲,組間比較差異有統計學意義(P＜0.05)；研究組B患者VAP髮生時間晚于研究組A,組間比較差異有統計學意義(P＜0.05).研究組A、B及對照組患者綠膿桿菌感染率分彆為7.4％ (4/54)、3.8％ (2/53)及34.0％ (18/53),研究組與對照組比較,差異有統計學意義(P＜0.05).結論 含加熱絲呼吸管路較普通管路可以降低早髮性VAP的髮生率,使髮生時間延遲；雙加熱絲較單加熱絲可更為有效的延遲VAP的髮生,併且降低遲髮性VAP髮生率；一次性加熱絲呼吸管路可降低綠膿桿菌感染率.
목적 탐토함가열사호흡관로재예방호흡궤상관성폐염(VAP)적림상개치.방법 장아원ICU수치적유창궤계통기환자완전수궤분위대조조(53례),연구조A(54례)화연구조B(53례).대조조호흡궤관로불함가열도사,연구조A재흡기경로함유가열도사(단가열사),연구조B재흡기화호기경로균함유가열도사(쌍가열사).관찰병비교각조환자VAP적발생솔、발생시간이급인기VAP적병원균.결과 연구조A화B환자적조발성VAP발생솔[분별위5.6％ (3/54)、3.8％(2/53)]균명현저우대조조[26.4％(14/53)],차이유통계학의의(균P＜0.05).연구조B환자적지발성VAP발생솔[9.4％(5/53)]명현저우대조조화연구조A[분별위22.6％(12/53)、24.1％ (13/54)],조간비교차이유통계학의의(P＜0.05).연구조A화B환자VAP발생시간균교대조조연지,조간비교차이유통계학의의(P＜0.05)；연구조B환자VAP발생시간만우연구조A,조간비교차이유통계학의의(P＜0.05).연구조A、B급대조조환자록농간균감염솔분별위7.4％ (4/54)、3.8％ (2/53)급34.0％ (18/53),연구조여대조조비교,차이유통계학의의(P＜0.05).결론 함가열사호흡관로교보통관로가이강저조발성VAP적발생솔,사발생시간연지；쌍가열사교단가열사가경위유효적연지VAP적발생,병차강저지발성VAP발생솔；일차성가열사호흡관로가강저록농간균감염솔.
Objective To explore the clinical value of heating wire of disposable breath pipeline for preventing ventilator-associated pneumonia(VAP)in mechanically ventilated patients.Methods All patients who received mechanical ventilation(M V)were randomly divided into three groups:control group,treatment group A and treatment group B.There was not a heating wire in the breath pipeline of control group.There was one heating wire in the inspiratory pipeline of group A.There were two heating wires in the inspiratory and expiratory pipelines of group B.The number of the patients who got VAP and the time of getting VAP and the pathogenic bacteria of VAP were observed and compared.Results The incidences of early VAP of group A and B were all much lower than those of control group [5.6％(3/54)vs 26.4％(14/53),3.8％(2/53)vs 26.4％ (14/53),P＜0.05].The incidences of late VAP of group B was much lower than those of group A and control group [9.4％ (5/53)vs 22.6％ (12/53),9.4％ (5/53)vs 24.1％ (13/54),P ＜ 0.05].The time of getting VAP in group A and B were all later than that in the control group (P ＜ 0.05).The time of getting VAP in group B is later than group A (P ＜ 0.05).The infection rate of pseudomonas aeruginosa in group A,group B and control group were 7.4％ (4/54),3.8％ (2/ 53)and 34.0％ (18/53)(P ＜ 0.05).Conclusions The use of heating wire of disposable breath pipeline has lower incidence of the early VAP and later onset of VAP than general breath pipeline.The use of twin heating wire of disposable breath pipeline has lower incidence of the delayed VAP and later onset of VAP than a single heating wire of disposable breath pipeline.The use of heating wire can reduce the infection rate of pseudomonas aeruginosa.
