机械式过滤器应用于机械通气患者的安全性研究

Clinical study on security of mechanical filter in patients with mechanical ventilation

目的 探讨机械式过滤器应用于机械通气患者的安全性.方法 选择机械通气并常规气道湿化患者60例,随机分成两组,30例加用机械式过滤器治疗者为治疗组,另30例未使用过滤器者为对照组.观察两组患者呼吸功能（机械通气第l天的2 h、12 h、24 h的气道平台压力、内源性呼气末正压及动脉血二氧化碳分压）的变化、呼吸机相关性肺炎的发生率和病死率.结果 机械式过滤器在临床使用过程中不会增加患者呼吸道阻力,不增加患者呼吸做功,未发生因阻塞而引起的高碳酸血症 机械式过滤器使用后呼吸机相关性肺炎发生率明显低于对照组（26.7%与56.7%,x2=5.554,P=0.018）.结论 机械式过滤器可安全用于机械通气患者,并降低呼吸机相关性肺炎发生率.

Objective To investigate the security of mechanical filter in mechanical ventilation for ICU patients.Methods 60 patients treated with mechanical ventilation and conventional airway humidification were selected and randomly divided into treatment group（mechanical filter treatment） and control group（non filter treatment） ,30 cases in each group.The changes of respiratory function（airway plateau pressure,endogenous PEEP and arterial carbon dioxide partial pressure of 2h,12h,24h at the first day of mechanical ventilation） ,and the incidence and mortality of ventilator-associated pneumonia were observed.Results The study showed airway resistance and the work of breathing in treatment group did not increase,and no hypercapnia due to congestion occurred.The incidence of ventilator-associated pneumonia in treatment group was significantly lower than that of the control group （26.7% vs 56.7% ,x2 = 5.554,P = 0.018）.Conclusion Mechanical filer applied in patients with mechanical ventilation was safe and could decrease the incidence of ventilator-associated pneumonia.