国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2013年
10期
748-751
,共4页
机械通气%持续性声门下吸引%间歇性声门下吸引%呼吸机相关性肺炎
機械通氣%持續性聲門下吸引%間歇性聲門下吸引%呼吸機相關性肺炎
궤계통기%지속성성문하흡인%간헐성성문하흡인%호흡궤상관성폐염
Mechanical ventilation%Continuous aspiration of subglottic secretion%Intermittent aspiration of subglottic secretion%Ventilator-associated pneumonia
目的 比较持续性声门下吸引(CASS)和间歇性声门下吸引(IASS)在预防呼吸机相关性肺炎(VAP)中的临床价值,及其对气道黏膜的影响.方法 将ICU收治的116例机械通气患者随机分为3组:CASS组(40例)、IASS组(38例)和对照组(不行声门下吸引,38例).记录并比较3组患者早发性和晚发性VAP发病率、发生时间,以及CASS组、IASS组患者气囊上方吸引液潜血阳性例数.结果 ①CASS组和IASS组的早发性和晚发性VAP发病率相似,差异无统计学意义(P＞0.05).CASS组和IASS组的早发性和晚发性VAP发病率均低于对照组(P＜0.05或P＜0.01).②CASS组和IASS组VAP发生时间晚于对照组(P＜0.05).CASS组和IASS组VAP发生时间相似,差异无统计学意义(P＞0.05).③IASS组的气囊上方吸引液潜血阳性率低于CASS组(P＜0.05).结论 CASS和IASS均可降低早发性和晚发性VAP发病率,并延迟VAP的发生,两者临床效果相似.但IASS有更低的气囊上方气道黏膜损伤风险.
目的 比較持續性聲門下吸引(CASS)和間歇性聲門下吸引(IASS)在預防呼吸機相關性肺炎(VAP)中的臨床價值,及其對氣道黏膜的影響.方法 將ICU收治的116例機械通氣患者隨機分為3組:CASS組(40例)、IASS組(38例)和對照組(不行聲門下吸引,38例).記錄併比較3組患者早髮性和晚髮性VAP髮病率、髮生時間,以及CASS組、IASS組患者氣囊上方吸引液潛血暘性例數.結果 ①CASS組和IASS組的早髮性和晚髮性VAP髮病率相似,差異無統計學意義(P＞0.05).CASS組和IASS組的早髮性和晚髮性VAP髮病率均低于對照組(P＜0.05或P＜0.01).②CASS組和IASS組VAP髮生時間晚于對照組(P＜0.05).CASS組和IASS組VAP髮生時間相似,差異無統計學意義(P＞0.05).③IASS組的氣囊上方吸引液潛血暘性率低于CASS組(P＜0.05).結論 CASS和IASS均可降低早髮性和晚髮性VAP髮病率,併延遲VAP的髮生,兩者臨床效果相似.但IASS有更低的氣囊上方氣道黏膜損傷風險.
목적 비교지속성성문하흡인(CASS)화간헐성성문하흡인(IASS)재예방호흡궤상관성폐염(VAP)중적림상개치,급기대기도점막적영향.방법 장ICU수치적116례궤계통기환자수궤분위3조:CASS조(40례)、IASS조(38례)화대조조(불행성문하흡인,38례).기록병비교3조환자조발성화만발성VAP발병솔、발생시간,이급CASS조、IASS조환자기낭상방흡인액잠혈양성례수.결과 ①CASS조화IASS조적조발성화만발성VAP발병솔상사,차이무통계학의의(P＞0.05).CASS조화IASS조적조발성화만발성VAP발병솔균저우대조조(P＜0.05혹P＜0.01).②CASS조화IASS조VAP발생시간만우대조조(P＜0.05).CASS조화IASS조VAP발생시간상사,차이무통계학의의(P＞0.05).③IASS조적기낭상방흡인액잠혈양성솔저우CASS조(P＜0.05).결론 CASS화IASS균가강저조발성화만발성VAP발병솔,병연지VAP적발생,량자림상효과상사.단IASS유경저적기낭상방기도점막손상풍험.
Objective To compare the clinical preventive effects between continuous aspiration of subglottic secretion (CASS) and intermittent aspiration of subglottic secretion (IASS) on ventilatorassociated pneumonia (VAP),and study the tracheal wall injury of them.Methods 116 patients,who received mechanical ventilation,were randomly divided into three groups:CASS group (40 cases),IASS group (38 cases),and control group (38 cases,not received aspiration of subglottic secretion).The number of patients who got VAP,the time of getting VAP,and the positive number of occult blood of secretion upper cuff were observed.Results ① The morbidity of early-onset VAP or late-onset VAP:CASS group and IASS group were both much lower than control group (P ＜0.05 or P ＜0.01).But there was no statistical difference between CASS group and IASS group (P ＞0.05).②The time of getting VAP:CASS group and IASS group were both later than control group (P ＜0.05).But there was no statistical difference between CASS group and lASS group (P ＞0.05).③The positive rate of occult blood test in IASS group was lower than that in CASS group (P ＜0.05).Conclusions Both CASS and IASS can decrease the morbidity of early-onset and late-onset VAP.And they can delay the occurrence time of VAP.They have the same clinical effect.But the risk of tracheal wall injury in IASS is lower than that in CASS.
