无湿化中低流量吸氧预防心血管疾病患者肺部感染的临床研究

Clinical research on non-wetting low-to-moderate flow oxygen to prevent pulmonary infections in patients with cardiovascular diseases

目的：探讨无湿化中低流量吸氧对心血管疾病患者肺部感染的影响，为心血管疾病患者寻求良好的吸氧方式，以降低肺部感染率。方法选取2011年3月－2014年3月心血管疾病患者341例，随机分为两组，对照组168例患者实施常规湿化吸氧，观察组173例患者实施无湿化吸氧，分别于开始吸氧后2、4、6、8、10、12、24、48 h通过鼻导管进行细菌培养，于吸氧开始后24、48、72 h调查两组患者鼻腔和口咽部干燥程度。结果开始吸氧后2h两组患者导管均无细菌检出，4h观察组鼻导管仍无细菌检出，对照组细菌检出阳性率为1．78％，两组比较差异无统计学意义；开始吸氧后6、8、10、12、24、48 h对照组患者鼻导管细菌检出阳性率为4．16％～63．69％，观察组为0．58％～1．73％，观察组细菌检出阳性率低于对照组，两组比较差异有统计学意义（ P＜0．05）；开始吸氧后24、48、72 h两组患者鼻腔和口咽部干燥程度相比，差异均无统计学意义。结论对心血管疾病患者实施无湿化中低流量吸氧较湿化吸氧可减少肺部感染发生率，而不增加患者的不适感。

OBJECTIVE To investigate the effects of non‐wetting low‐to‐moderate flow oxygen on nosocomial pul‐monary infections in patients with cardiovascular diseases and seek a good approach for oxygen inhalation for pa‐tients with cardiovascular diseases to reduce pulmonary infection .METHODS Totally 341 patients with cardiovas‐cular diseases during Mar .2011 to Mar .2014 were randomly divided into two groups .The control group of 168 patients received conventional wet oxygen and the observation group of 173 patients received non‐wetting oxygen . Bacterial culture was conducted through a nasal catheter at 2 h ,4 h ,6 h ,8 h ,10 h ,12 h ,24 h after the begin‐ning of oxygen inhalation .The dryness of nasal cavity and oropharynx was investigated in the two groups at 24 h , 48 h ,and 72 h after oxygen inhalations .RESULTS No bacteria were detected in the catheter in either group at 2 h after the beginning of oxygen inhalation .At 4 h ,still no bacteria were detected in the nasal catheter in the obser‐vation group and the positive detection rate was 1 .78% in the control group .At 6 h ,8 h ,10 h ,12 h ,24 h and 48 h after the beginning of oxygen inhalation ,the positive bacterial detection rate was 0 .58% ‐1 .73% in the observa‐tion group ,lower than 4 .16% ‐63 .69% in the control group ,the difference was significant （P〈0 .05） .There was no difference in dryness of nasal cavity and oropharynx between the two groups at 24 h ,48 h ,and 72 h after the beginning of oxygen inhalation .CONCLUSION Non‐wetting low‐to‐moderate flow oxygen for patients with car‐diovascular diseases can reduce the incidence of pulmonary infections without increasing patient discomfort .