三种不同呼吸道湿化方法对呼吸机相关性肺炎发生率的影响

Effects of Three Different Airway Humidification Methods on Incidence of Ventilator-associated Pneumonia

目的探讨三种不同呼吸道湿化方式对呼吸机相关性肺炎发生率的影响。方法选择2006年9月至2008年9月入住本院重症监护病房建立人工呼吸道并应用呼吸机患者共60例,按照入院先后设立3组,每组20例,分别为人工鼻+即时湿化组(A组),持续点滴组(B组,用输液泵控制滴速)、湿化器组(C组)。每组观察时间为2～4周,观察指标包括体温、血白细胞计数、中性白细胞计数、痰培养结果等等。结果B组患者呼吸机相关性肺炎发生率最低,为20%,与其他两组的差异有统计学意义(χ2=19.798,P<0.01)。结论持续点滴湿化法(用输液泵控制滴速)在预防呼吸机相关性肺炎发生中具有良好的效果。

Objective To investigate the influence of three different airway humidification methods on incidence of ventilator-associated pneumonia （VAP）. Methods Sixty patients with artificial airway and mechanical ventilator in ICU of Ruijin hospital from Sep 2006 to Sop 2008 were equally divided into three groups based on order sequences： Group A treated with instant humidification and artificial nose,Group B with lasting humidification and infusion set;Group C with humiditifior. Temperature,leucocyte numbers, neutrophillic leucocyte, bacterial culture of sputum of all the patients were observed for 2 to 4 weeks. Results Patients with lasting humidification and infusion set had the lowest incidence（20%） of VAP,which had significant difference compared with other groups（x^2= 19. 798, P〈0. 01）. Conclusions Lasting humidification with infusion set was expected to be a better solution for airway humidification.