持续气囊上方低负压吸引预防呼吸机相关性肺炎的临床观察

Clinical effect of continuous aspiration of subglottic secretions on the prevention of ventilator-associated pneumonia in mechanically ventilated patients

目的持续气囊上方低负压吸引预防呼吸机相关性肺炎的疗效。方法将96例需进行机械通气患者随机分成对照组和治疗组,对照组采用传统q2h进行吸痰,不冲洗,不持续负压吸引,治疗组在对照组上进行持续低负压吸引并间隔冲洗。结果治疗组发生呼吸相关性肺炎的发生率25.0%,对照组47.92%,差异有显著性(χ2=4.50,P<0.05);治疗组发生呼吸机相关性肺炎平均时间(12.53±2.9)d,对照组(7.2±2.7)d,组间差异有显著性(χ2=8.42,P<0.05)。结论持续气囊上方低负压吸引,可有效减少呼吸机相关性肺炎的发生,而且是安全的。

[ Objective ] To evaluate the effect of continuous aspiration of subglottic secretions （CASS） on the prevention of ventilator-associated pneumonia （VAP） in mechanically ventilated patients. [ Method ] 96 Patients ventilated mechanically were randomly divided into 2 groups： One group received CASS and the other did not （NCASS group）. CASS was performed immediately after admission of patients in the CASS group. Thereafter just sputum suction every two hours was performed for patients in the NCASS group. [Result] The morbidity of VAP in the CASS and the NASS groups was 25,0% and 47.9% respectively （X^2=4.50, P 〈0.05）, and the length of time before the onset of VAP in these 2 groups was （12.53 ± 2.9） days and （7.2 ± 2.7） days respectively （X^2=8.42, P 〈0.05）. There was statistically significant difference between the two groups. [ Conclusion ] Effective continuous aspiration of subglottic secretions could significantly reduce the morbidity of early-onset VAP.