中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2013年
16期
16
,共1页
韩晓红%郑瑞云%杨玲瑗%廖燕如%黄艳%陶艳
韓曉紅%鄭瑞雲%楊玲瑗%廖燕如%黃豔%陶豔
한효홍%정서운%양령원%료연여%황염%도염
人工气道%套囊内压力%呼吸机相关性肺炎
人工氣道%套囊內壓力%呼吸機相關性肺炎
인공기도%투낭내압력%호흡궤상관성폐염
Artificial airway%Cuff pressure%Ventilator-associated pneumonia
目的:探讨不同人工气道套囊压力监测频率对长期机械通气患者呼吸机相关性肺炎发生的影响.方法:采用前瞻性研究方法,选择2009年12月-2013年1月深圳市第二人民医院重症监护病房需机械通气大于7 d的76例重症患者.将所有研究对象按随机化原则分为试验组和对照组,各38例.试验组采用每4小时监测及调整人工气道套囊压力,对照组采用每8小时监测及调整人工气道套囊压力.对比试验组及对照组气道黏膜损伤情况,对比试验组及对照组每次监测时的套囊压力,观察两组患者呼吸机相关性肺炎的发生率.结果:(1)试验组与对照组均未发生气道黏膜损伤的情况;(2)试验组与对照组调整前的套囊平均压力分别为(25.62±3.15)、(18.21±3.16)cm H2O,两组比较差异有统计学意义(t=21.66,P<0.01);(3)试验组与对照组呼吸机相关性肺炎发生率分别为15.21%、31.14%,两组比较差异有统计学意义(字2=5.33,P=0.02).结论:增加调整套囊压力次数,可使人工气道套囊压力维持在预期范围,可减少呼吸机相关性肺炎的发生率,而不增加气损伤.
目的:探討不同人工氣道套囊壓力鑑測頻率對長期機械通氣患者呼吸機相關性肺炎髮生的影響.方法:採用前瞻性研究方法,選擇2009年12月-2013年1月深圳市第二人民醫院重癥鑑護病房需機械通氣大于7 d的76例重癥患者.將所有研究對象按隨機化原則分為試驗組和對照組,各38例.試驗組採用每4小時鑑測及調整人工氣道套囊壓力,對照組採用每8小時鑑測及調整人工氣道套囊壓力.對比試驗組及對照組氣道黏膜損傷情況,對比試驗組及對照組每次鑑測時的套囊壓力,觀察兩組患者呼吸機相關性肺炎的髮生率.結果:(1)試驗組與對照組均未髮生氣道黏膜損傷的情況;(2)試驗組與對照組調整前的套囊平均壓力分彆為(25.62±3.15)、(18.21±3.16)cm H2O,兩組比較差異有統計學意義(t=21.66,P<0.01);(3)試驗組與對照組呼吸機相關性肺炎髮生率分彆為15.21%、31.14%,兩組比較差異有統計學意義(字2=5.33,P=0.02).結論:增加調整套囊壓力次數,可使人工氣道套囊壓力維持在預期範圍,可減少呼吸機相關性肺炎的髮生率,而不增加氣損傷.
목적:탐토불동인공기도투낭압력감측빈솔대장기궤계통기환자호흡궤상관성폐염발생적영향.방법:채용전첨성연구방법,선택2009년12월-2013년1월심수시제이인민의원중증감호병방수궤계통기대우7 d적76례중증환자.장소유연구대상안수궤화원칙분위시험조화대조조,각38례.시험조채용매4소시감측급조정인공기도투낭압력,대조조채용매8소시감측급조정인공기도투낭압력.대비시험조급대조조기도점막손상정황,대비시험조급대조조매차감측시적투낭압력,관찰량조환자호흡궤상관성폐염적발생솔.결과:(1)시험조여대조조균미발생기도점막손상적정황;(2)시험조여대조조조정전적투낭평균압력분별위(25.62±3.15)、(18.21±3.16)cm H2O,량조비교차이유통계학의의(t=21.66,P<0.01);(3)시험조여대조조호흡궤상관성폐염발생솔분별위15.21%、31.14%,량조비교차이유통계학의의(자2=5.33,P=0.02).결론:증가조정투낭압력차수,가사인공기도투낭압력유지재예기범위,가감소호흡궤상관성폐염적발생솔,이불증가기손상.
Objective:To investigate the effect of different monitoring frequency of artificial airway cuff pressure on the ventilator-associated pneumonia occurrence of long-term mechanical ventilation patients.Methods:A prospective study was conducted.76 cases with mechanical ventilation lasting longer than 7 days were studied in the ICU of Shenzhen Second People’s Hospital.76 cases were randomly divided into experimental group and control group with 38 cases in each.The artificial airway cuff pressure of the experimental group was monitored and adjusted every 4 hours,and the artificial airway cuff pressure of the control group was monitored and adjusted every 8 hours. The airway mucosal injury of the experimental group and the control group was compared.The cuff pressure of experimental group and control group as monitoring was compared.The ventilator-associated pneumonia occurrence rate of two groups was observed.Results:(1) The experimental group and the control group showed no airway mucosal injury.(2)The cuff average pressure of the experimental group and the control group were (25.62±3.15) and (18.21± 3.16)cm H2O,the difference was statistically significant(t=21.66,P<0.01).(3)The ventilator-associated pneumonia incidence of the experimental group and the control group were 15.21%and 31.14%,the difference was statistically significant(χ2=5.33,P=0.02).Conclusion:The increase of the adjustment times of cuff pressure can make the artificial airway cuff pressure in the expected rangeand reduce the occurrence rate of VAP without increasing the airway injury.
