持续气道湿化与间断雾化吸入对重型颅脑损伤气管切开患者气道湿化效果观察

Effect of continuous airway humidification and intermittent atomization inhalation on airway humidification in patients with severe craniocerebral injury undergoing tracheotomy

目的探讨持续气道湿化与间断雾化吸入对重型颅脑损伤气管切开患者气道湿化的效果。方法采用前瞻性研究法,选取南阳市第二人民医院2020年1月至2021年12月期间收治的重型颅脑损伤行气管切开患者72例,按随机数字表法分为对照组和观察组,各36例。对照组中男23例,女13例,年龄24~67(44.32±4.72)岁,采取间断雾化吸入方法。观察组中男24例,女12例,年龄20~65(43.96±5.25)岁,采取持续气道湿化方法。比较两组患者痰液湿化效果、患者舒适度、睡眠质量及并发症发生率。采用t检验、χ^(2)检验及秩和检验进行分析。结果两组一般资料比较,差异均无统计学意义(均P>0.05)。观察组痰液湿化效果优于对照组,差异有统计学意义(Z=2.567,P=0.010)。干预前,两组患者的Koicaba舒适状况量表(GCQ)、匹兹堡睡眠质量指数量表(PSQI)评分比较,差异均无统计学意义(均P>0.05);干预后,观察组GCQ评分为(78.19±5.48)分,高于对照组的(70.35±6.63)分,PSQI评分为(7.93±1.25)分,低于对照组的(11.27±2.54)分,差异均有统计学意义(t=5.469、7.079,均P<0.05)。观察组并发症发生率为11.11%(4/36),低于对照组的33.33%(12/36),差异有统计学意义(χ^(2)=5.143,P<0.05)。结论持续气道湿化在重型颅脑损伤气管切开患者中的应用效果优于间断雾化吸入,利于增强湿化效果,提高患者舒适度和睡眠质量,降低并发症发生率。

Objective To investigate the effect of continuous airway humidification and intermittent atomization inhalation on airway humidification in patients with severe craniocerebral injury undergoing tracheotomy.Methods A prospective study was conducted.Seventy-two patients with severe craniocerebral injury who underwent tracheotomy in Nanyang Second People's Hospital from January 2020 to December 2021 were selected,and were divided into a control group and an observation group by the random number table method,with 36 cases in each group.The control group had 23 males and 13 females who were 24-67(44.32±4.72)years old,and they were treated by the intermittent atomization inhalation method.The observation group had 24 males and 12 females who were 20-65(43.96±5.25)years old,and they were treated by the continuous airway humidification method.The sputum humidification effects,patient comfort,sleep quality,and incidences of complications were compared between the two groups.t test,χ^(2) test,and rank-sum test were used for the analysis.Results There were no statistical differences in the general data between the two groups(all P>0.05).The effect of sputum humidification in the observation group was better than that in the control group,with a statistical difference(Z=2.567,P=0.010).Before the intervention,there were no statistical differences between the two groups in the scores of Koicaba Comfort Scale(GCQ)and Pittsburgh Sleep Quality Index(PSQI)(both P>0.05).After the intervention,the scores of GCQ and PSQI were(78.19±5.48)and(7.93±1.25)in the observation group,and were(70.35±6.63)and(11.27±2.54)in the control group,with statistical differences(t=5.469 and 7.079,both P<0.05).The incidence of complications in the observation group was lower than that in the control group[11.11%(4/36)vs.33.33%(12/36)],with a statistical difference(χ^(2)=5.143,P<0.05).Conclusions The application effect of continuous airway humidification in patients with severe craniocerebral injury undergoing tracheotomy is better than that of intermittent atomization inhalation;it is conducive to enhance the humidification effect,improve the patients'comfort and sleep quality,and reduce the incidence of complications.