机械通气患者微量泵持续滴注气道湿化与注射器间歇灌注湿化的临床效果对比研究

Comparison on clinical effects of airway humidity methods between minim pump infusion and syringe intermittent perfusion on patients with mechanical ventilation

目的观察并对比机械辅助通气患者行微量泵持续滴入气道湿化与注射器间歇灌注湿化的临床效果与并发症发生情况。方法前瞻性分析解放军总医院外科监护室2010年10月～2012年5月入选的行机械通气的98例患者资料,单盲分为A(50例)、B(48例)两组,A组患者采用微量泵持续滴入气道湿化,B组采用注射器间歇气道灌注湿化,辅助通气3d后观察两组气道湿化效果,并对比辅助通气期间并发症发生情况与护理工作量。结果①A组患者通气3d后痰液较之B组稀薄,且PaO2、SpO2指标明显高于B组,差异有统计学意义(P<0.05);②A组患者刺激性咳嗽次数、痰痂形成例数、呼吸机相关肺炎(VAP)发生例数均低于B组,且痰痂形成率与VAP发生率差异有统计学意义(P<0.05);③B组患者通气时间、吸痰次数均高于A组(P<0.05)。结论微量泵持续滴入较注射器间歇灌注气道湿化效果更佳,并发症更少,且能有效减少护理工作量,具备推广价值。

Objective To conduct a comparison on clinical eitect and comphcations＇ incidence between minim pump infusion airway humidity method and syringe intermittent perfusion method on patients with assisted mechanical ven- tilation. Methods Prospective study was conducted on 98 admitted inpatients with mechanical ventilation ranging from October 2010 to May 2012, 98 cases were randomized into A （50 cases） and B （48 cases） group single blindly, cases in group A were exerted sustained minim pump infusion method to conduct airway humidification, meanwhile, cases in group B were applied syringe intermittent perfusion, 3 days later after assisted ventilation, effects of airway humidification were compared on indicators of sputum density and blood gas indexes, besides, complications＇ incidence and corresponding nursing workloads were also compared between two groups. Results ①Patients in group A compared with group B whose sputum were thiner, and indicators of PaO2, SpO2 were superior than those of group B, and the differences were statistically significant （P 〈 0.05）; ②paticnts in group A with irritative coughing, phlegm scab formation, ventilator-associated pneumonia （VAP） were less than those of group B, moreover, incidences of phlegm scab formation and VAP between two groups were statistically different （P 〈 0.05）; ③Patients of group B whose ventilation time, suctioning frequencies were both higher than those of group A （P 〈 0.05）. Conclusion Compared with syringe intermittent perfusion, minim pump infusion method whose airway humidity effect is better, with fewer complications, and can effectively reduce nursing workloads, deserving clinical promotion.