自制声门下吸引气管导管预防呼吸机相关性肺炎的效果观察

Effect observation of tracheal vessel which could be use to draw the subglottic secretion made by ourselves preventing ventilator-associated pneumonia

目的观察自制声门下吸引气管导管预防呼吸机相关性肺炎(VAP)的效果。方法选择2009年11月～2012年1月入住急诊科和ICU的接受机械通气治疗的脑外伤和脑卒中患者50例,随机分成两组。对照组22例,使用普通气管导管进行气管插管;研究组28例,使用自制声门下吸引气管导管进行气管插管。机械通气14 d,比较两组VAP的发生率;比较机械通气14 d内两组出现的VAP患者及VAP平均出现时间的早晚。结果机械通气14 d,对照组发生VAP 11例,发生率为50.0%;研究组发生VAP 6例,发生率为21.4%,两组比较差异有统计学意义(P<0.05)。对照组VAP平均发生时间为9.9 d;研究组VAP平均发生时间为12.5 d,研究组VAP发生时间比对照组晚,两组比较差异有统计学意义(P<0.05)。结论应用自制声门下吸引气管导管能降低VAP发生率和推迟VAP发生时间,能有效预防VAP。

Objective To observe the effect of tracheal vessel which could be use to draw the subglottic secretion made by ourselves preventing ventilator-associated pneumonia （VAP）. Methods Fifty patients with cerebral trauma or stroke who received mechanical ventilation therapy and were hospitalized the Emergency Department and ICU from Nov 2009 to Jan- uary 2012 were randomly divided into two groups. The contrast group with 22 patients received common trachea vessel; The research group with 28 patients received tracheal vessel which could be use to draw the subglottic secretion made by ourselves. To compare the incidence of the VAP of the two groups when they received mechanical ventilation therapy for 14 days;To compare the average time at which the VAP of the VAP patients of the two groups occurred who suffered the VAP within 14 days at witch time they were receiving mechanical ventilation therapy. Results When they received me- chanical ventilation therapy for 14 days, 11 patients of the contrast group suffered from VAP,and the incidence of the ~AP was 50.0% ;6 patients of the research group suffered from VAP,and the incidence of the VAP was 21.4% ;There was obvi- ous difference in the incidence of the VAP between the two groups （P 〈 0.05）. The average time when the YAP of the contrast group occurred were 9.9 days ;The average time when the VAP of the research group occurred were 12.5 days ;The average time when the VAP of the research group occurred were later than the average time when the VAP of the contrast group occurred, and there was obvious difference in the time when the VAP occurred between the two groups （P 〈 0.05）. Conclusion The application of the tracheal vessel which can be use to draw the subglottic secretion made by ourselves can reduce the incidence of the VAP and postpone the time when the VAP occurs. That is to say,it can effectively prevent the occurrence of the VAP.