人工鼻在CCU气管插管患者中的应用

Application of artificial nose in CCU patients with tracheal intubation PAN

目的探讨人工鼻在CCU气管插管患者中的应用效果。方法将62例气管插管患者随机分为人工鼻组（n=32例）与电热恒温湿化组（n=32例），比较两组患者痰液黏稠度、刺激性呛咳、气道管理耗时数、平均插管时间、气道耗材费用、呼吸机相关肺炎发生率等情况。结果人工鼻组发生刺激性呛咳28．1％、呼吸机相关肺炎发生率15．6％、气道管理耗时数（2．3±0．5）h、平均插管时间（112±6．5）h、气道耗材费用（44．2±6．7）元均优于电热恒温湿化组71．9％，37．5％，（3．5±0．6）h，（133±7．8）h，（56．3±1．5）元，差异均有统计学意义（X2分别为12.25，3．9250；t分别为8．6605，11．6998，8．2129；P〈0.01或P〈0.05）；人工鼻组痰液黏稠度Ⅰ度12．5％，Ⅱ度62．5％，Ⅲ度25．0％，电热恒温湿化组Ⅰ度46．9％，Ⅱ度25．0％，Ⅲ度28．1％，两组比较差异具有统计学意义（x2=11．5590，P〈0．01）。结论人工鼻应用于气管插管患者，可达到理想的气道湿化效果，并能有效提高气道管理效能，省时节力，降低呼吸机相关肺炎发生率，可在临床推广应用。

Objective To explore the application efficacy of artificial nose in CCU patients with tracheal intubation. Methods Totals of 62 patients with tracheal intubation were randomly divided into the group of artificial nose and group of electrothermal and constant temperature moist, then the sputum viscosity, irritating cough, airway administration hours, average intubation time, consumables costs, and the incidence of ventilator-associated pneumonia intwo groups were observed and compared. Results In artificial nose group, the incidence of irritating cough was28. 1%, the incidence of ventilator-associated pneumonia was 15.6% , airway administration hours was（2. 3±0. 5 ） b, average intubation time was （ 112±6.5 ） h, consumables costs was （44.2±6.7）yuan all better than that of electrothermal and constant temperature moist group, which was 71.9% ,37.5%, （3.5±0.6 ） h, （ 133±7.8 ） h, and （ 56.3±1.5 ） yuan, respectively, differences were statistically significant（x2 = 12.25,3. 925 0;t = 8. 660 5,11. 699 8,8. 212 9, respeetively;P 〈0. 01 or P 〈 0.05）. Sputum viscosity status of artificial nose group was that Ⅰgrade 12.5% , Ⅱ grade 62.5%, Ⅲ grade 25.0% ,whilethat of electrothermal and constant temperature moist group was 46.9%,25.0% ,28.1%, respectively, and the differences was statistically significant （ X2 = 11. 559 0, P 〈 0. 01 ）. Conclusions Artificial nose using in patients with endotracheal intubation can achieve the desired efficacy of airway humidification, improve the efficacy of airway administration, save energy and time and significantly reduce the incidence of ventilator-associated pneumonia, which likely to be generally used in clinical.