气囊上吸引加呋喃西林冲洗对呼吸机相关性肺炎的预防作用研究

Study for preventive effect of ventilator associated pneumonia treated by air bag suching plus furacilin washing

目的探讨气管切开气囊上吸引加0.2%呋喃西林气囊上冲洗在预防呼吸机相关肺炎(VAP)的临床价值。方法将90例气管切开行机械通气患者随机分为3组,每组各30例。对照组(A组):常规吸痰,对气囊滞留物不做处理;囊上吸引组(B组):对气囊滞留物进行吸引,8 h1次;0.2%呋喃西林冲洗组(C组):对气囊滞留物进行吸引,同时进行0.2%呋喃西林冲洗,8 h1次;记录三组患者3 d、6 d9、d、12 d、15 d气管切开气囊上和气囊下滞留物的细菌培养结果,呼吸机相关肺炎发生的例数,并进行统计学处理。结果C组细菌总量明显少于A组和B组,差异具有统计学意义(P<0.01,P<0.05);B组细菌量少于A组,差异有显著性意义(P<0.05);3 d、6 d、9 d后,发生VAP的例数A组为4、6、9例,B组为2、3、4例,C组为0、1、2例。三组比较,C组发生率明显低于A、B两组(P<0.05)。结论气管切开气管插管气囊上吸引加呋喃西林冲洗,可预防呼吸机相关肺炎的发生。

Objective To evaluate the clinical preventive efficacy of ventilator associated pneumonia（VAP） treated by air bag suching plus 0.2% furacilin washing. Method 90 patients with incision of trache were randomly divided into three groups., control group （group A） applying routine sputum suncking, group B applying air bag suching 8 hours per times, and group C applying 0.2% furacilin washing and air bag suching 8 hours per time. The results of cultivated bacteria and VAP patients was recorded and analyzed. Result The bacteria account in group C was the lowest among the three group（P〈0.01）. The bacteria account in group B was lower than that of group A（P〈0.05）. The case of VAP patients in group A was 4,6,and 9 after 4,6 and 9 days, there was 2,3 and 4 case in group B. and 0,1 ,and 2 case in group C. the occurrence rate in group C was significantly lower than thant of group B and group A （P〈0.05）. Conclusion The ventilator associated pneumonia can be prevented by air bag suching plus furacilin washing after incision of trache.