三种不同气道湿化方法对建立人工气道脱机患者效果研究

A Comparative Study on Three Different Airway Humidification Methods for Patients with Artificial Airway Offline

目的探讨建立人工气道脱机患者应用不同主动气道湿化方法的气道湿化效果。方法纳入2012年1月至2013年12月建立人工气道不需要机械通气治疗时间≥72 h的危重患者155例,随机分为3组,A组采用MR410湿化装置,B组采用MR850湿化装置,C组采用AIRVO2呼吸湿化治疗装置。分别测量各组患者72 h后呼吸频率、PaO2、SpO2、心率;采用气道分泌物评分评价痰液黏稠度;记录肺部感染控制的时间。结果三组患者在性别、年龄、病种、建立人工气道时间、急性生理与慢性健康评分系统Ⅱ评分、诊断等方面差异均无统计学意义(P>0.05)。三组患者呼吸频率、PaO2、SpO2、心率、痰液黏稠度、湿化效果及肺部感染控制的时间比较差异均有统计学意义(P<0.05)。结论与MR410、MR850湿化装置比较,AIRVO2呼吸湿化治疗装置更适用于建立人工气道脱机患者,是更理想的气道湿化方法。

Objective To compare the effects of different airway humidification methods for patients with artificial airway offline. Methods One hundred and fifty-five critically ill patients with artificial airway who did not need mechanical ventilation for more than 72 h,admitted in the Affiliated Hospital to Armed Police Logistics College between January 2012 and December 2012,were recruited in the study. They were randomly divided into 3 groups to receive different airway humidification treatment,ie. MR410 device for group A,MR850 device for group B,AIRVO2 device for group C. PaO2,SpO2,heart rate,and breathing frequency were measured after 72 h. The Airway Scoring System was used for evaluation of sputum viscosity.The time of pulmonary infection control was also recorded. Results There were no significant differences in gender,age,underlying diseases,duration of artificial airway,and APACHE Ⅱ score among three groups（ P 〉0.05）. There were significant differences in respiratory frequency,PaO2,SpO2,heart rate,sputum viscosity,humidification effect,lung infection control time among three groups（ P 〈 0. 05）,with group C better than group A and B in above parameters. Conclusions Compared with MR410 and MR850 humidification devices,AIRVO2 is a more ideal device for airway humidification,and is more suitable for patients with artificial airway offline.