呼吸机管路及湿化装置更换周期的研究

The research on replacement cycle of ventilator tube system and humidification device

目的:探讨有创机械通气条件下呼吸机管路及湿化装置合理的更换周期。方法:将11例呼吸衰竭行机械通气患者随机分为3天组、4天组和5天组,3组分别于机械通气开始后3、4、5天采集呼吸机管路吸气段、呼气段、螺纹管、吸气段及呼气段冷凝器、湿化罐6个部位标本,并进行细菌学检测。结果:呼吸机管路、冷凝器连续使用5天更换细菌阳性率明显高于3天、4天更换;呼吸机管路中螺纹管带菌率高于吸气段、呼气段;3组湿化罐细菌检测均未有细菌;患者APACHEⅡ评分、意识、咳嗽反射强弱与管路带菌率的关系,不同组、咳嗽反射强弱与管路带菌率有相关性。结论:通过3组患者的观察,认为呼吸机管路合理的更换时间为连续使用第5天更换。

Objective：To study an appropriate replacement cycle of ventilator tube system and humidification device in invasive mechanical ventilation.Methods：110respiratory failure patients with invasive mechanical ventilation were randomly divided into 3rd day group,4th day group and 5th day group.6samples were collected from ventilator tube system and conducted bacteriological testing.It is inspiratory segment,expitatory paragraph,threaded circuit,conderser in inspiratory and expiratory, and humidifier.The time of sample collection of three groups was 3rd day,4th day and 5th day of mechanical ventilation respectively.Results：The bacterial positive in ventilator circuit and conderser replacement of 5days of continuous use was significantly higher than 3days and 4days.Threaded circuit in the carrier rate is higher than inspiratory and expiratory segment.Bcteria in humidifier were not developed in 3groups.APACHEⅡscore,consciousness,cough reflex intensity and circuit carrier rate of patients had relationship with positive rate of bacterial culture.Conclusion：The appropriate replacement cycle of ventilator tube system and humidification device is 5th day.