一体式与分组式吸氧雾化装置在肝癌术后患者的应用效果:前瞻性病例对照研究

Application effect of integrated and grouped oxygen inhalation atomization devices in postoperative patients with liver cancer:a prospective case-control study

目的比较两种氧气和雾化吸入装置在肝部分切除术后患者的应用效果,以期为临床氧气及雾化吸入方式的选择提供参考。方法采用前瞻性病例对照研究方法,选取2022年1–12月期间于四川大学华西医院肝脏外科全身麻醉下行肝癌切除术后需行氧气吸入和雾化吸入治疗的患者228例作为研究对像,采用随机数字表法随机分为2组,即分组式组(n=77)和一体式组(n=151)。分组式组采用临床常用的传统氧气吸入装置和雾化装置(分组式吸氧雾化装置),每24 h更换潮化瓶及湿化用水。一体式组则采用集氧气吸入和雾化功能为一体的新装置(一体式氧气雾化吸入装置),一体式组再根据更换潮化瓶及湿化用水的时间不同分为一体式1组(n=77)和一体式2组(n=74);一体式1组更换潮化瓶及湿化用水的时间同分组式组,一体式2组更换潮化瓶及湿化用水的时间为在使用后48 h更换、更换后在使用72 h后再更换。分组式组和一体式1组分别于吸氧后24 h、48 h、72 h、96 h和120 h采集2组潮化瓶中不同部位样本进行菌落培养,一体式2组则在2次更换装置时(48 h和120 h)取样进行菌落培养。同时测量护士雾化操作时间和2组的雾化噪音;采用自制的患者和护士满意度问卷分别对2组患者和30位护士进行满意度调查。结果分组式组和一体式1组菌落数在不同时段组内比较和同时相2组间比较差异均无统计学意义(P>0.05);雾化性能方面,一体式组雾化噪音低于分组式组(P<0.05),一体式组的雾化准备和用物处置时间均短于分组式组(P<0.05);患者及护士对一体式组满意度更高(P<0.05)。结论一体式与分组式氧气雾化潮化瓶污染风险无差异,一体式氧气雾化吸入的雾化性能和湿化性能均优于分组式,工作时产生的噪音小,患者舒适度高,可缩短护士操作时间,提高工作效率,具有较高的临床应用价值。

Objective To compare the application effects of two kinds of oxygen and nebulizer inhalation devices applied to patients undergoing partial hepatectomy,with a view to providing reference for clinical selection oxygen and nebulizer inhalation modality.Methods A prospective case-control study was used to select 228 patients who required oxygen inhalation and nebulization after hepatectomy under general anesthesia in the Department of Liver Surgery of West China Hospital of Sichuan University from January to December 2022 as study subjects,and were randomly divided into two groups:grouping group(n=77)and integrating group(n=151).The traditional oxygen inhalation device and atomization device(grouping oxygen inhalation atomization device)commonly used in clinic were used in the grouping group,and the humidifying bottle and humidifying water were replaced every 24 hours.The integrating group adopts a new device(integrated oxygen atomization inhalation device)which integrates oxygen inhalation and atomization functions.The integrating group was divided into integrating group 1(n=77)and integrating group 2(n=74)according to the different time of changing the humidifying bottle and humidifying water.The time for replacing the humidifying bottle and humidifying water in the integrating 1 was the same as that in the grouping group.The time for replacing the humidifying bottle and humidifying water in the integrating group 2 was 48 h after used,and replace again it after 72 hours of used.Samples from different parts of the grouping group and the integrating group 1 were collected at 24 h,48 h,72 h,96 h and 120 h after oxygen inhalation,respectively,for colony culture.In the integrating group 2,samples were taken for colony culture when the device was changed twice(48 h and 120 h).At the same time,the nurses’fogging operation time and the fogging noise of the two groups were measured.The self-made patients’satisfaction questionnaire and nurses’questionnaire were used to investigate the satisfaction of two groups of patients and 30 medical staff respectively.Results There were no statistically significant difference in the number of bacterial colonies between the grouping group and the integrating group 1 at different time periods and between the two groups at the same time(P>0.05).In terms of atomization performance,atomization noise in the integrating group was lower than that of the grouping group(P<0.05),and the atomization preparation and disposal time in the integrating group were shorter than that of the grouping group(P<0.05).The patients and nurses were more satisfied with the integrating group(P<0.05).Conclusions There is no difference in pollution risk between the integrated oxygen atomization bottle and the grouped oxygen atomization bottle.The atomization performance and humidification performance of the integrated oxygen atomization bottle are better than that of the grouped oxygen atomization bottle.The noise generated during operation is small,the comfort of patients is high,and the operation time of nurses can be shortened and the work efficiency can be improved,which has high clinical application value.