定期更换不同长度气管套管预防机械通气气道并发症的临床研究

Research on preventing airway complication in mechanical ventilation patients by applying different lengths of catheter

目的研究不同长度气管套管在长期机械通气患者预防并发症的应用效果。方法选取住老年病房呼吸科并行气管切开长期(大于6个月)机械通气的患者59例,采用随机数字法分为对照组30例、实验组29例,每2个月更换导管1次,对照组每次常规使用8 cm导管,实验组使用统一型号3种不同长度导管,分别为8 cm导管、9 cm导管、10 cm导管。结果两组内囊压力高压发生率和气道黏膜损伤情况相比较,差异具有统计学意义(P<0.01)。结论应用不同长度气管套管,可以改变患者局部组织受压部位,缩短同一点受压迫、刺激的时间,从而降低气道并发症发生率;同时,不同长度气管套管使用安全,值得临床推广应用。

Abjective To study the effect of different lengths of catheter in long-term mechanical ventilation patients on preventing long-term mechanical ventilation complication. Methods 59 patients on mechanical ventilation and incision of tracheal （time 〉 6 months） in Department of Respiratory Medical were selected. 30 patients who had begun to use respirator on evennumbered days were assigned to the control group, and the other 29 patients who had begun to use respirator on odd-numbered days were assigned to the test group. In the control group, patients exchanged the catheter once every 2 months,using an 8 centimeters long catheter. In the test group,patients exchanged the catheter once every 2 months,using different lengths of catheter （8 cm,9 cm, 10 cm）. Results By comparison,the rate of high intracapsular pressure was quiet different,as demonstrated by statistic （P 〈 0.01） . And there was statistical significance between the two groups in the damage of the airway mucosa （P 〈 0.01）. Conclusion Airway complication can be reduced by using different lengths of catheter, changing the pressed part of the local tissue, and shortening the time of being pressed and stimulated at the same part. At the same time,it is safe to use different lengths of catheter;this method could be promoted.