改良型呼吸机连接管对机械通气患者呼吸机相关性肺炎的预防作用研究

Study on the preventive effect of modified ventilator connecting tube on ventilator-associated pneumonia in patients receiving mechanical ventilation

目的探讨改良型呼吸机连接管对机械通气患者呼吸机相关性肺炎(VAP)的预防作用。方法选取2019年7—12月120例在佛山市第二人民医院行机械通气干预的危重症患者,按照随机数字对照表法分为A组、B组和C组,每组各40例。A组采用常规加热湿化器(HHs)+普通呼吸机延长管治疗,B组采用湿热交换器(HMEs)+普通呼吸机延长管治疗,C组采用常规HHS+改良呼吸机延长管治疗。对各组患者VAP发生率、多重耐药菌的感染率、住院时长、住院总费用及机械通气时间进行统计。结果B组、C组患者的VAP发生率、多重耐药菌的感染率、住院时长、住院总费用及机械通气时间比较,差异无统计学意义(P>0.05)。B组、C组患者的VAP发生率、多重耐药菌的感染率、住院时长、住院总费用及机械通气时间均低于A组患者,差异有统计学意义(P<0.05)。结论改良型呼吸机连接管可显著降低VAP的发生,缩短患者机械通气时间、留院时间,减少医疗费用,可在广大基层医院及欠发达地区推广应用。

Objective To investigate the preventive effect of modified ventilator connecting tube on ventilator-associated pneumonia(VAP)in patients receiving mechanical ventilation.Methods A total of 120 critically ill patients who underwent mechanical ventilation intervention in the Second People's Hospital of Foshan from July to December 2019 were divided into the group A,group B and group C according to the randomized controlled number table method,each group were 40 cases.Group A was treated with conventional heated humidifiers(HHs)+conventional ventilator extension tube,group B was treated with heat and moisture exchangers(HMEs)+normal ventilator extension tube,and group C was treated with conventional HHS+modified ventilator extension tube.The incidence of VAP,infection rate of multi-drug resistant bacteria,length of stay,total hospitalization cost and duration of mechanical ventilation in the three groups were counted.Results There were no statistically significant differences between group B and group C in the incidence of VAP,infection rate of multi-drug resistant bacteria,length of stay,total hospitalization cost and duration of mechanical ventilation(P>0.05).The incidence of VAP,infection rate of multi-drug resistant bacteria,length of stay,total hospitalization cost and duration of mechanical ventilation were lower/shorter in group B and group C than in group A,with statistically significant differences(P<0.05).Conclusion The modified ventilator connecting tube can significantly lower the incidence of VAP,shorten the duration of mechanical ventilation and length of stay,and reduce medical costs,and can be widely applied in grass-roots hospitals and underdeveloped areas.