CAJ | 학술논문

目的探讨吸入性损伤气管切开病人适宜有效的气道湿化方法.方法将36例吸入性损伤气管切开病人随机分为观察组和对照组,观察组用灭菌注射用水持续气管内滴入湿化气道,并动态观察病人气道湿化情况,根据吸出痰液粘稠度调整湿化液滴速;对照组采用传统方法,使用注射器每2h向气管内滴入0.9％氯化钠溶液2～4 ml湿化气道.比较两组病人痰液粘稠度、吸痰效果、气道并发症发生情况.结果观察组病人痰液Ⅲ度粘稠发生率5.6％,每天吸痰次数为(17.72±1.57)次,痰培养阳性率为11.1％;对照组病人痰液Ⅲ度粘稠发生率55.6％,每天吸痰次数为(20.61±1.26)次,痰培养阳性率为50％,两组病人痰液稀释情况、吸痰效果、气道并发症发生情况比较差异有显著性(P＜ 0.05).结论对吸入性损伤气管切开病人,使用灭菌注射用水持续滴入湿化气道并做到动态观察气道湿化情况,及时调整湿化液滴速,效果优于使用0.9％氯化钠溶液定时湿化气道,能有效稀释痰液、湿化气道、减少吸痰次数和气道并发症.
목적 탐토흡입성손상기관절개병인괄의유효적기도습화방법.방법 장36례흡입성손상기관절개병인수궤분위관찰조화대조조,관찰조용멸균주사용수지속기관내적입습화기도,병동태관찰병인기도습화정황,근거흡출담액점주도조정습화액적속;대조조채용전통방법,사용주사기매2h향기관내적입0.9％록화납용액2～4 ml습화기도.비교량조병인담액점주도、흡담효과、기도병발증발생정황.결과 관찰조병인담액Ⅲ도점주발생솔5.6％,매천흡담차수위(17.72±1.57)차,담배양양성솔위11.1％;대조조병인담액Ⅲ도점주발생솔55.6％,매천흡담차수위(20.61±1.26)차,담배양양성솔위50％,량조병인담액희석정황、흡담효과、기도병발증발생정황비교차이유현저성(P＜ 0.05).결론 대흡입성손상기관절개병인,사용멸균주사용수지속적입습화기도병주도동태관찰기도습화정황,급시조정습화액적속,효과우우사용0.9％록화납용액정시습화기도,능유효희석담액、습화기도、감소흡담차수화기도병발증.
Objective To explore effective humidity therapies for patients undergoing tracheal resection due to inhalation injury.Methods 36 patients undergoing tracheal resection due to inhalation injury were randomly divided into study group and control group.The study group received continuous intratracheal drip of sterilized water for injection and the speed of dripping was adjusted according to the viscosity of the aspired sputum.The control group received conventional therapy with intratracheal drip of 0.9％ sodium chloride solution of 2 to 4ml for airway humidity every 2 hours.Viscosity of sputum,efficacy of sputum aspiration,and incidence of airway complications were compared between the two groups.Results In the study group,the rate of grade Ⅲ viscosity was 5.6％,the frequency of daily sputum aspiration was (17.72 ± 1.57)times,and the positive rate of sputum culture was 11.1％; while in the control group,the rate of grade Ⅲ viscosity was 55.6％,the frequency of daily sputum aspiration was (20.61 ± 1.26)times,and the positive rate of sputum culture was 50％.Dilution of sputum,efficacy of sputum aspiration,and incidence of airway complications differed significantly between the two groups (P ＜ 0.05).Conclusions For patients undergoing tracheal resection due to inhalation injury,continuous intratracheal drip of sterilized water for injection with a proper speed of dripping is superior to regular intratracheal drip of 0.9％ sodium chloride solution.The previous approach can effectively dilute sputum,humify airway,and reduce the frequency of sputum aspiration and the airway complications.