ICU气管切开术后两种声门下滞留物吸引方法的效果比较

Study on the efficacy of two kinds of subglottic suction in patients with tracheotomy

目的探讨ICU气管切开术后患者应用不同声门下滞留物吸引方法的效果。方法选择ICU行气管切开、机械通气的患者104例,按入院序号分为A组和B组,每组52例。A组采用持续声门下吸引加间断冲洗的方法,B组采用间断吸引、冲洗的方法,对两组患者机械通气期间的生命体征、血气分析结果、排痰量、声门下滞留物吸引量、呼吸机相关性肺炎(VAP)、呛咳等的发生情况进行统计和观察。结果两组1周内发生VAP的例数、VAP发生的时间、呛咳等发生情况的差异有统计学意义(P<0.05);两组生命体征、血气分析结果、排痰量、声门下滞留物吸引量、VAP发生率的差异无统计学意义(P>0.05)。结论对ICU气管切开术后患者进行声门下持续负压吸引加间断冲洗,不仅可以提高吸引效果,而且可以减少并发症的发生。

Objective To compare the efficacy of two kinds of subglottic suction in patients with tracheotomy. Methods Totally 104 patients with tracheotomy receiving mechanical ventilation were randomly divided into group A and group B. Group A received continuous suction of subglottic secretion with interval wash,while group B receiving only interval wash and suction. The vital signs,results of blood gas analysis,volume of sputum,volume of retention,incidence of ventilator associate pneumonia （VAP） and symptoms of cough were recorded. Results There were significant differences between two groups in the incidence of VAP within one week,timing of VAP occurrence and symptom of cough（P〈0.05）. There were no significant differences in vital signs,results of blood gas analysis,volume of sputum,volume of retention,and the total incidence of VAP（P〉0.05）. Conclusion Continuous suction of subglottic secretion with interval wash can improve the efficacy of suction and reduce complications.