PALL BB25S呼吸过滤器滤菌性能的临床研究

Clinical study on efficacy of bacteriological filtration for PALL BB25S breathing filter

目的联合应用多种方法探讨PALL BB25S呼吸过滤器的疏水性能及对细菌的滤过效应。方法选择2005年1月至2006年1月于河北省人民医院行气管插管全麻术后病例202例进行回顾性研究，分为应用PALL BB25S呼吸过滤器组（P组）（98例）和未用呼吸过滤器组（C组）（104例）。对两组下呼吸道感染的发生率进行比较。用混合有血浆的生理盐水，逐滴对PALL BB25S呼吸过滤器膜行液体渗透性测试。建立模拟通气环路（呼吸过滤器放置在呼吸环路与模拟肺之间），依次进行Ⅰ：在呼吸过滤器的模拟肺侧加菌液1ml；Ⅱ：加生理盐水11ml后加菌液1ml。呼吸机纯氧模拟机械通气至少3h，在滤过膜模拟肺侧、滤过膜呼吸环路侧和呼吸螺纹管Y型接头内侧分别采样，标本孵育24h后观察菌落生长情况。结果随测试液不断加入，测试液不断蓄积在加液体侧，无液体渗入滤过膜或从对侧渗出。滤过膜呼吸环路侧和呼吸螺纹管Y型接头内侧的细菌滤过阳性率均为0％。P组全麻术后下呼吸道感染率（1．0％）低于C组（6．7％）（χ^2=4．326，P=0．039）。结论PALL BB25S呼吸过滤器疏水性能好，能有效滤过呼吸回路中细菌，减少全麻术后下呼吸道感染的发生。

Objective To observe the efficacy on hydrophobicity and bacteriological filtration of PALL BB25S breathing filter（BF） by multiple methods. Methods Retrospective investigation was conducted on the patients who had suffered from surgery operation from January 2005 to January 2006, and the rate of lower breathing system infection was compared between the patients who had used PALL BB25S BF during operation（group P） and the ones who had not used any BF during operation （group C）. The membrane of BF by dropping sodium chloride fixed plasma was tested. The mechanical model was set up（its turn is breathing circuit,BF,and imitated lung）. The following two treatments were randomly tested on each BF. Ⅰ ：to add 1 ml liquid fixed bacterium to one side of BF which closed to the chloride,and then add 1 ml bacterial liquid. After ventilating for no imitated lung; Ⅱ ：to add 11 ml sodium less than 3 hours, the samples from the imitated lung side of BF, the other side and the Y connectors were respectively taken. The samples were cultured for 24 hours and observed. Results When the tested liquid was ceaselessly dropped, it was accumulated but not infiltrated or effused from the opposite side. No bacterium was observed on the second and third sample spot in two treatments. Infection rate of lower respiratory tract after operation in group P （1.0%） was lower than that in group C （6.7%） （χ^2 = 4. 326, P =0. 039）. Conclusions For the perfect hydrophbicity of PALL BB25S breathing filter,it effectively filtrates the bacterium of breathing circuit and decreases the lower respiratory infection.