一次性气管切开集痰保湿防护罩在气管切开术后患者气道湿化中的应用效果

Airway humidification of post-tracheotomy patients using a disposable sputum collection and moisture preservation cover

目的评价一次性气管切开集痰保湿防护罩在气管切开术后非机械通气患者气道湿化中的应用效果。方法选取气管切开术后非机械通气患者48例,随机将其分入传统组(n=16)、实验组(n=16)和对照组(n=16)。传统组采用2层湿纱布覆盖气管切开导管口进行湿化,实验组使用防护罩湿化,对照组使用人工鼻湿化。比较3组患者呼吸功能、气道温度和湿度、Ⅲ度黏痰以及湿化不足并发症的发生情况。结果3组患者血氧饱和度、动脉血氧分压和动脉血二氧化碳分压在时间效应、组间效应及交互效应上比较,差异均无统计学意义(P>0.05)。干预7 d后,实验组吸气温度高于对照组(P<0.05),吸气湿度低于对照组(P<0.05),且均高于传统组(P<0.05);3组呼气温度比较,差异无统计学意义(P>0.05),实验组与对照组呼气湿度差异无统计学意义(P>0.05),但2组均高于传统组(P<0.001);3组的痰液黏稠度比较,差异有统计学意义(χ2=6.400,P=0.041),3组气道出血及肺部感染发生率比较,差异无统计学意义(χ2=3.091,P=0.230;χ2=1.948,P=0.763)。结论一次性气管切开集痰保湿防护罩能提升气管切开术后患者气道温度和湿度,有效湿化气道。

Objective To evaluate the humidification of a kind of disposable sputum collection and moisture preservation cover for post-tracheotomy patients with non-mechanical ventilation.Methods Totally 48 post-tracheotomy patients without mechanical ventilation were randomized to a traditional group(n=16),an experimental group(n=16)and a control group(n=16).The tracheotomy tubes in the traditional group were covered by 2 layers of damp sterile gauze,the experimental group was given the protective cover,while the control group was employed the heat and moisture exchanger.The respiratory function,airway temperature and humidity,the incidence ofⅢdegree phlegm and insufficiency in humidification were compared among the three groups.Results There was no significant differences among the three groups in the saturation of haemoglobin with SpO 2,PaO 2 and PaCO 2(P>0.05 for all).After 7days intervention,the inspiratory temperature of the experimental group was significantly higher than that of the control group(P<0.05),but the inspiratory humidity was significantly lower than the latter(P<0.05),both significantly higher than that of the traditional group(P<0.05).There was no significant differences among the three groups in the expiratory temperature,there was no significant difference in the expiratory humidity between the experimental and control groups,both significantly higher than that of the traditional group(P<0.001).There was significant differences among the 3 groups in the phlegm viscosity(χ2=6.400,P=0.041).No significant differences were found among the 3 groups in the incidence of complications(χ2=3.091,P=0.230;χ2=1.948,P=0.763).Conclusion This kind of disposable sputum collection and moisture preservation cover can improve the temperature and humidity of the airway,and humidify the airway effectively.