中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
10期
13-14,15
,共3页
热湿交换细菌过滤器%密闭式吸痰%呼吸机相关性肺炎
熱濕交換細菌過濾器%密閉式吸痰%呼吸機相關性肺炎
열습교환세균과려기%밀폐식흡담%호흡궤상관성폐염
Heat-moisture exchange filters%Close endotracheal suctioning%Ventilator-associated pneumonia
目的：探讨热湿交换细菌过滤器联合密闭式吸痰预防呼吸机相关性肺炎（VAP）的临床效果。方法：选取2010-2011年在本院ICU进行机械通气的158例患者，按照随机数字表法将其分成试验组80例和对照组78例。试验组采用热湿交换细菌过滤器联合密闭式吸痰，对照组采用加热湿化器联合开放吸痰。两组患者均给予化痰止咳、解痉平喘、纠正内环境紊乱、抗感染、每日2次口腔护理和床头抬高30°及营养支持等对症治疗。观察比较两组患者VAP发病率、28 d死亡率、机械通气时间和ICU住院时间的差异。结果：试验组的VAP发病率28.75%明显低于对照组的46.15%，且28 d死亡率18.75%明显低于对照组的34.62%，差异均有统计学意义（P<0.05）。试验组的机械通气时间明显少于对照组，差异有统计学意义（P<0.05），两组ICU住院时间比较差异无统计学意义（P>0.05）。结论：热湿交换细菌过滤器联合密闭式吸痰可以降低VAP发病率、28 d死亡率，缩短机械通气时间，对ICU住院时间无影响。
目的：探討熱濕交換細菌過濾器聯閤密閉式吸痰預防呼吸機相關性肺炎（VAP）的臨床效果。方法：選取2010-2011年在本院ICU進行機械通氣的158例患者，按照隨機數字錶法將其分成試驗組80例和對照組78例。試驗組採用熱濕交換細菌過濾器聯閤密閉式吸痰，對照組採用加熱濕化器聯閤開放吸痰。兩組患者均給予化痰止咳、解痙平喘、糾正內環境紊亂、抗感染、每日2次口腔護理和床頭抬高30°及營養支持等對癥治療。觀察比較兩組患者VAP髮病率、28 d死亡率、機械通氣時間和ICU住院時間的差異。結果：試驗組的VAP髮病率28.75%明顯低于對照組的46.15%，且28 d死亡率18.75%明顯低于對照組的34.62%，差異均有統計學意義（P<0.05）。試驗組的機械通氣時間明顯少于對照組，差異有統計學意義（P<0.05），兩組ICU住院時間比較差異無統計學意義（P>0.05）。結論：熱濕交換細菌過濾器聯閤密閉式吸痰可以降低VAP髮病率、28 d死亡率，縮短機械通氣時間，對ICU住院時間無影響。
목적：탐토열습교환세균과려기연합밀폐식흡담예방호흡궤상관성폐염（VAP）적림상효과。방법：선취2010-2011년재본원ICU진행궤계통기적158례환자，안조수궤수자표법장기분성시험조80례화대조조78례。시험조채용열습교환세균과려기연합밀폐식흡담，대조조채용가열습화기연합개방흡담。량조환자균급여화담지해、해경평천、규정내배경문란、항감염、매일2차구강호리화상두태고30°급영양지지등대증치료。관찰비교량조환자VAP발병솔、28 d사망솔、궤계통기시간화ICU주원시간적차이。결과：시험조적VAP발병솔28.75%명현저우대조조적46.15%，차28 d사망솔18.75%명현저우대조조적34.62%，차이균유통계학의의（P<0.05）。시험조적궤계통기시간명현소우대조조，차이유통계학의의（P<0.05），량조ICU주원시간비교차이무통계학의의（P>0.05）。결론：열습교환세균과려기연합밀폐식흡담가이강저VAP발병솔、28 d사망솔，축단궤계통기시간，대ICU주원시간무영향。
Objective:To investigate the effects of heat-moisture exchange filters(HMEF)combined with close endotracheal suctioning(CES)on prevention of VAP in ICU patients.Method:158 patients who were treated with mechanical ventilation in our ICU from 2010 to 2011 were selected,they were randomly divided into the experimental group for 80 cases and the control group for 78 cases,the experimental group was treated with HMEF combined with CES,the control group was treated with heated humidifying system(HHS)combined with open endotracheal suctioning(OES). All patients were given Huatanzhike,antispasmodic,correction of the internal environment disorder,anti infection,2 times a day oral care and head elevation 30 ° and nutritional support treatment.Incidence of VAP,28-day mortality,the duration of mechanical ventilation and ICU stay were compared between the two groups.Result:The incidence rate of VAP in experimental group was 28.75%,it was significantly lower than the control group(46.15%),the 28 d mortality was 18.75%, it was lower than the control group(34.62%),the differences were statistically significant(P<0.05).The duration of mechanical ventilation in experimental group was less than that of the control group,the difference was statistically significant (P<0.05).There was no significant difference in length of stay in ICU between two groups(P<0.05).Conclusion:HMEF combined with CES can decrease incidence of VAP,28-day mortality in ICU patients and duration of mechanical ventilation, but not decrease length of stay in ICU.
