碳酸氢钠与甲硝唑在人工气道建立患者气道湿化中的临床应用

The clinical application of sodium bicarbonate and metronidazole for airway humidification in artificial airway patients

目的观察1.4%碳酸氢钠与0.2%甲硝唑注射液交替精密持续气道湿化临床运用效果。方法将68例建立人工气道的患者按照就诊顺序随机分成观察组和对照组各34例。观察组采用1.4%碳酸氢钠与0.2%甲硝唑交替用静推泵精密持续气道湿化,对照组采用0.9%氯化钠用静推泵精密持续气道湿化,对比2组的痰液黏稠度、吸痰次数、血氧饱和度、气道黏膜损伤出血状况、肺部听诊情况、肺部厌氧菌及真菌感染的发生率。结果观察组的痰液黏稠度73.58%,吸痰次数(76.26±2.53)次,气道黏膜损伤出血发生率5.16%,肺部听诊啰音阳性率18.81%,厌氧菌的感染发生率8.04%,真菌感染发生率10.47%,均低于对照组(P<0.05)。观察组的血氧饱和度为(96.38±2.23)%,高于对照组的(92.38±2.18)%(P<0.05)。结论采用1.4%碳酸氢钠与0.2%甲硝唑注射液交替精密持续气道湿化使痰液易抽吸,减少吸痰次数及气道黏膜损伤出血情况,改善氧合,有效地减少呼吸道厌氧菌及真菌感染的发生率,值得推广。

Objective To observe the clinical application of 1.4% sodium bicarbonate and 0.2% metronidazole to alter aero- bic bacteria and fungi precision continuous airway humidification in artificial airway patients. Methods 68 patients were randomly divid- ed into artificial airway observation group and the control group. The observation group used the 1.4% sodium bicarbonate and 0.2% metronidazole to continuous airway humidification by intravenous pump. The control group used 0.9% sodium chloride to continuous air- way humidification by intravenous pump too. Then the viscosity of the sputum, the times of sputum suction, oxygen saturation, the situation of airway mucosa bleeding injury status, auscultation of lungs and pulmonary anaerobic bacteria and fungi infection rate we compared. Results Theresults of the observation group were lower than those in the control group except the oxygen saturation. The viscosity of the sputum was 73.58% ：The times of sputum suction was （76.26 ± 2.53 ）times：The rate of the situation in airway mucosa bleeding injury status was 5.16% ：The positive rate of auscultation of lungs was 18.81% ：The infection rate of anaerobic bacteria was 8.04% ：The infec- tion rate of fungi was 5.16%. The oxygen saturation was （96.38 ± 2.23） higher than that in the control group. Conclusion It is very easy for sputum suction and reducing the times of sputum suction： and to improve the oxygen saturation, and to decrease the infection rate of anaerobic bacteria and fungi when use 1.4% sodium bicarbonate and 0.2% metronidazole.