智能型加温湿化氧疗对人工气道湿化效果的评价

Evaluation on effect of auto heated and humidified oxygen therapy for the intubated patients

目的:研究智能型加温湿化氧疗系统对气管插管患者湿化的效果。方法:107例气管插管患者(使用过呼吸机且已经脱离呼吸机者)吸入氧浓度在45%以下时,按照随机的原则分别给予A:智能型的加温湿化氧疗系统,B:干燥给氧加用一次性湿热交换器,C:湿化瓶湿化给氧加Q6H的沐舒坦15mg加入生理盐水5ml雾化吸入20min。每8h评估痰液黏稠度,直至拔管。3d内气管插管患者拔管时记录拔管时间及是否有肉眼可见的痰痂。结果:A组患者Ⅲ度痰液黏稠度及拔管时痰痂发生率分别为2/36、4/35;B组患者Ⅲ度痰液黏稠度及拔管时痰痂的发生率分别为12/36、15/34;C组患者Ⅲ度痰液黏稠度及拔管时痰痂的发生率分别为8/35、11/34。智能型加温湿化器氧疗患者痰液黏稠度Ⅲ度及痰痂形成率低于一次性湿热交换器、雾化吸入患者(P<0.05),同时雾化吸入患者痰液黏稠度Ⅲ度及痰痂形成率低于一次性湿热交换器患者(P<0.05),差异有统计学意义。结论:智能型的加温湿化氧疗系统与一次性的湿热交换器及雾化器相比,其可以提供满意的湿化效果,有效预防湿化不足导致痰液黏稠,有效避免肉眼可见气道痰痂的形成。

Objective：To investigate the humidified effect of auto heated and humidified oxygen therapy for the intubated patients. Method： 107 cases of intubated patients with FiO2〈45% were randomly assigned to auto heated and humidified oxygen therapy（Group A）,oxygenated with heat and moisture exchanger （Group 13）,traditional humidified oxygen by oxygen cylinder in combination with aerosol inhalation with Mucosolvanfor 20 minutes every 6 hrs （Group C）. The sputum viscosity was valued every 8 hours till extubation. The extubation time and visible sputum crust was recorded for 72 hrs. Result： The incidence of Ⅲ° sputum viscosity and sputum crust were 2/36 and 4/35 （Group A）,12/36 and 15/34 （Group B）,as well as 8/35 and 11/34 （Group C）. Ⅲ° sputum viscosity in Group A were less than Group B and Group C（P〈0.05）. Sputum crust in Group A were less than Group B and Group C, too（P〈0.05）, existing significant statistic difference. Conclusion.. Auto heated and humidified oxygen therapy is better than heat and moisture exchanger and aerosol inhalation for intubated patients in humidification. It could provide the satisfactory humidified effect and prevent from the formation of sputum crust and thickness sputum caused by the insufficiency of humidifying.