喉全切术后行持续声门下吸引预防下呼吸道感染的临床研究

Study on the prevention of lower respiratory tract infection after the continuous operation of the patients with laryngeal complete resection of the inferior vena cava

目的探讨喉癌喉全切术后持续声门下腔下吸引预防下呼吸道感染的临床效果。方法选取我科喉癌喉全切术后患者40例,随机分为两组(对照组20例,观察组20例)。对于观察组,持续应用负压吸引装置,对照组不应用。治疗期间首日及每隔3日将气道滞留物标本进行真菌和细菌培养。以上操作严格在无菌条件下进行。观察两组患者在治疗期间下呼吸道感染的发生率,以及气道滞留物的菌落培养情况。结果患者下呼吸道感染的发病率对照组(40.0%)比观察组(15.0%)明显较高,差异有统计学意义(P<0.05);革兰阳性球菌菌落发现率,观察组(5.0%)显著低于对照组(25.0%),差异有统计学意义(P<0.05);革兰阴性球菌菌落发现率,观察组(15.0%)显著低于对照组(35.0%),差异有统计学意义(P<0.05);非发酵菌菌落发现率,观察组(10.0%)显著低于对照组(25.0%),差异有统计学意义(P<0.05)。结论喉癌喉全切术后持续声门下腔下吸引术,能够明显改善各类细菌、真菌的上呼吸道滞留率;同时降低下呼吸道感染的发病率,值得临床推广应用。

Objective To explore the clinical effect of continuous negative pressure suction for the prevention of lower respiratory tract infection in patients with laryngeal squamous cell carcinoma. Methods 40 patients with laryngeal carcinoma were randomly divided into two groups：20 cases in the control group and 20 cases in the observation group. For the observation group,continuous application of negative pressure suction device,the control group does not apply. Fungal and bacterial cultures were performed on the first day of treatment and at every three days. The above operation is strictly carried out under sterile conditions. The incidence of lower respiratory tract infection in two groups was observed,and the colony culture of airway was observed. Results The incidence of respiratory infection in patients with the control group（40%）than in the observation group（15%）was significantly higher,the difference was statistically significant（P〈0.05）;gram positive cocci were found,the observation group（5%）was significantly lower than the control group（25%）,the difference was statistically significant（P〈0.05）;gram negative bacteria colony detection rate,the observation group（15%）was significantly lower than the control group（35%）,the difference was statistically significant（P〈0.05）;non fermenting bacteria colony detection rate,the observation group（10%）was significantly lower than the control group（25%）,the difference was statistically significant（P〈0.05）. Conclusion Continuous aspiration of inferior vena cava in patients after total laryngectomy can significantly reduce the various bacteria and fungi retention rate of the upper respiratory tract,while avoiding the incidence of lower respiratory tract infection rate,it is worthy of clinical application.