CAJ | 학술논문

目的：探讨人工气道机械通气患者气囊上滞留物引流对呼吸机相关性肺炎（VAP）及致病菌的影响。方法将2011年3月至2012年9月于本院重症监护病房（ICU）建立人工气道，且机械通气超过72 h的患者106例随机分为气囊上滞留物引流组（实验组）56例和非引流组（对照组）50例，记录 VAP发生时间、气道开放时间、ICU住院时间、总住院时间，不同类型标本病原学培养、鉴定结果及患者病死率等。结果实验组患者 VAP发病率、气道开放时间、ICU住院时间、总住院时间、病死率等明显低于对照组（P＜0．05）；下呼吸道痰液标本病原学培养结果与气囊上滞留物培养结果一致。结论气囊上滞留物引流可以明显降低 ICU人工气道机械通气患者 VAP发病率，缩短气道开放时间、ICU住院时间及总住院时间，降低病死率；清除气囊上滞留物可减少气囊上致病菌侵入下呼吸道，避免下呼吸道感染的发生，是预防 VAP的有效方法。
목적：탐토인공기도궤계통기환자기낭상체류물인류대호흡궤상관성폐염（VAP）급치병균적영향。방법장2011년3월지2012년9월우본원중증감호병방（ICU）건립인공기도，차궤계통기초과72 h적환자106례수궤분위기낭상체류물인류조（실험조）56례화비인류조（대조조）50례，기록 VAP발생시간、기도개방시간、ICU주원시간、총주원시간，불동류형표본병원학배양、감정결과급환자병사솔등。결과실험조환자 VAP발병솔、기도개방시간、ICU주원시간、총주원시간、병사솔등명현저우대조조（P＜0．05）；하호흡도담액표본병원학배양결과여기낭상체류물배양결과일치。결론기낭상체류물인류가이명현강저 ICU인공기도궤계통기환자 VAP발병솔，축단기도개방시간、ICU주원시간급총주원시간，강저병사솔；청제기낭상체류물가감소기낭상치병균침입하호흡도，피면하호흡도감염적발생，시예방 VAP적유효방법。
Objective To explore the influence of subglottic secretion drainage (SSD)on ventilator associated pneumonia (VAP)and pathogenic bacteria in patients treated by mechanical ventilation (MV).Methods From Mar. 2010 to Sep.2012,106 patients,treated by MV for more than 72 hours in Intensive Care Unit (ICU),were randomly divided into SSD group (experiment group,n=56)and non-SSD group (control group,n=50).Clinical data,such as onset time of VAP,duration of MV,length of stay in ICU,etiology culture results and the mortality were recorded. Results The incidence of VAP,duration of MV,length of stay in ICU and the mortality in experiment group were lower than control group (P<0.05).Etiology culture results of SSD were similar to lower respiratory secretion.Con-clusion SSD could reduce the incidence rate of VAP,trachea opening time,length of stay in ICU,hospitalization time and mortality rate.SSD could also avoid the infection of lower respiratory tract via inhibiting bacterial motility.SSD might be an effective method for the prevention of VAP.