气管插管持续湿化对预防肺部感染的效果分析

Effect of sustained humidification of endotracheal intubation on prevention of pulmonary infections

目的研究可湿化气管插管持续湿化气道对降低痰液黏稠度、避免反复吸痰导致气道黏膜损伤及预防肺部感染的效果,为临床治疗提供参考依据。方法调查2011年1月-2013年2月共387例行气管插管的患者临床资料,选择2011年1-12月219例患者随机分为两组,对照1组92例患者采用普通气管插管,试验1组127例患者采用可湿化气管插管,选择同样0.45%氯化钠湿化液;选择2012年9月-2013年2月168例,将其随机分为试验2组、对照2组,各84例,观察各组患者肺部感染的发生率。结果试验1组患者湿化合格93例、合格率73.23%,对照1组患者湿化合格22例、合格率23.91%,两组患者合格率比较差异有统计学意义(P<0.01);试验2组患者肺部感染发生率为22.62%,明显低于对照组的54.76%,差异有统计学意义(P<0.05)。结论用可湿化气管插管的专用湿化通道持续湿化,避免了频繁吸痰对气道黏膜损伤引起的感染、避免了痰液蓄积滋生细菌生长,对维持气道黏膜自净功能及预防肺部感染效果显著。

OBJECTIVE To explore the effect of the sustained humidification of endotracheal intubation on reduction of sputum viscosity and prevention of repeated suction‐induced airway mucosa damage as well as pulmonary infec‐tions so as to provide guidance for clinical treatment .METHODS The clinical data of 387 patients who underwent the endotracheal intubation from Jan 2011 to Feb 2013 were investigated ;totally 219 patients who were treated from Jan 2011 to Dec 2011 were randomly divided into two groups ,92 patients in the control group 1 were treated with the common endotracheal intubation ,127 patients in the experimental group 1 were given the humidified en‐dotracheal intubation plus 0 .45% sodium chloride solution ;while 168 patients who were treated from Sep 2012 to Feb 2013 were assigned and randomly divided into the experimental group 2 and the control group 2 ,with 84 cases in each ;the incidence of pulmonary infections was observed .RESULTS Totally 93 patients were qualified for the humidification in the experimental group 1 with the qualified rate of 73 .23% ;22 cases were qualified for the hu‐midification in the control group 1 with the qualified rate of 23 .91% ,there was significant difference in the quali‐fied rate between the two groups （P＆lt;0 .01） .The incidence of pulmonary infections of the experimental group 2 was 22 .62% ,significantly lower than 54 .76% in the control group （P＆lt; 0 .05） .CONCLUSION The sustained humidification of endotracheal intubation through dedicated channels can contribute to the prevention of infections induced by airway mucosa damage due to frequent sputum suction and avoid the bacterial growth induced by the sputum accumulation ,which can achieve significant effect on maintaining the airway mucosa self‐purification func‐tion and prevention of pulmonary infections .