喷射雾化器持续雾化对气管切开气道湿化作用的研究

Study of humidifying effect of continuous atomization with jet nebulizer on tracheostomy airway

目的探讨喷射雾化器持续雾化对气管切开气道的湿化作用。方法气管切开患者90例,随机分为实验组及对照组各45例。实验组应用氧气驱动喷射雾化器,在雾化器内加无菌注射用水持续雾化进行气道湿化,对照组应用输液泵将无菌注射用水持续泵入气道进行湿化。结果实验组患者湿化满意度、呼吸音改善优于对照组,湿化不足、肺部感染发生率低于对照组,吸痰间隔时间长于对照组,PaO2、SaO2高于对照组,PaCO2低于对照组,差异均具有显著性。结论利用喷射雾化器持续雾化进行气道湿化,效果良好,并且操作简单、方便吸痰,洗涤消毒彻底,值得临床推广。

Objective To study the humidifying effect of continuous atomization with jet nebulizer on tracheostomy airway. Methods Ninety patients with tracheostomy were randomly divided into observing group （ n = 45 ） and control group （ n = 45 ）. There were no statistical difference in age, gender and underlying disease. In observing group, patients were treated with continuous humidification for endotracheal airway by oxygen jet nebulizer with sterile water for injection. In control group, patients were treated with continuous humidification for endotracheal airway by infusion pump with sterile water for injection. Results In observing group and control group the satisfied rates of humidification were 88.9% and 55.6% （X^2 = 16.4615, P 〈 0.01 ）, improving rates of respiratory sound were 84.4% and 48.9% （X^2 = 12. 8000,P 〈0.01 ） ,insufficient rates of humidification were 4.4% and 33.3% （X^2 = 12. 2562,P 〈0.01 ） ,pulmonary infection rate were 17.8% and 31.1% （X^2 = 3. 8603, P 〈 0.05）, intervals of suction were 1.96± 0.28 hours and 1.45 ± 0.35 hours （t = 7. 6328,P 〈 0.01 ）, PaO2 was 12.2 ±2.3 kPa and 10.5 ±2.1 kPa （ t = 3. 6616, P 〈 0.01 ）, SaO2 was 93.5 ± 3.2 kPa and 87.6 ±4.5 kPa, （ t = 6.6210, P 〈 0.01 ）, PaCO2 was 5.2 ±0.9 kPa and 6.5 ± 1.1 kPa （ t = 3. 3039,P 〈 0.01 ）, respectively. Conclusions It is an effective, simple and easy way to remove the sputum with continuous humidifying endotracheal airway by oxygen jet nebulizer.