振动筛孔雾化器连接有创呼吸机管路对结构性肺病合并呼吸衰竭的应用效果

The Application of a Vibrating Mesh Nebulizer Connected to An Invasive Ventilator Circuit in Patients with Structural Lung Disease Complicated by Respiratory Failure

目的探讨振动筛孔雾化器连接有创呼吸机管路对结构性肺病合并呼吸衰竭患者的临床疗效。方法选取2022年8月至2023年8月收治的40例结构性肺病合并呼吸衰竭患者,按照随机数字表法将其分为对照组(n=20)和观察组(n=20)。2组患者均予有创呼吸机辅助呼吸,对照组予空气压缩雾化器治疗,观察组予振动筛孔雾化器治疗,观察2组呼吸机相关指标、雾化相关操作指标、血气分析以及康复情况。结果雾化治疗时,2组患者呼吸频率比较差异无统计学意义(P>0.05);观察组气道峰压(PIP)、潮气量(VT)水平均低于对照组(P<0.05);雾化用时、雾化操作时间、雾化药物剩余量以及呼吸机潮气量报警次数观察组均少于对照组(P<0.05)。2组雾化治疗后氧分压(PaO_(2))水平均较雾化治疗前升高,二氧化碳分压(PaCO_(2))水平均较雾化治疗前降低(P<0.05);雾化治疗1周时,观察组PaO_(2)较对照组升高,PaCO_(2)水平较对照组降低(P<0.05)。结论振动筛孔雾化器与空气压缩雾化器应用于结构性肺病合并呼吸衰竭的治疗,可改善患者血气分析指标,但振动筛孔雾化器对患者潮气量的影响更小,药物利用率更高,且操作用时更短。

Objective To explore clinical efficacy of a vibrating mesh nebulizer connected to an invasive ventilator circuit in patients with structural lung disease and respiratory failure.Methods 40 patients with structural lung disease who also exhibited respiratory failure admitted from August 2022 to August 2023 were selected and divided into the control group(n=20)and the observation group(n=20)according to the method of randomized numerical table;the patients in both groups were given invasive ventilator-assisted respiration,with air-compressing nebulizer in the control group and vibrating mesh nebulizer in the observation group;ventilator-related indexes,nebulizer-related indexes and recovery conditions were monitored in the 2 groups.Results During nebulization,there were no statistically significant differences in respiratory rate between the 2 groups(P>0.05);however,the peak inspiratory pressure(PIP)and tidal volume(VT)levels in the observation group were significantly lower than those in the control group(P<0.05).Additionally,nebulization time,operational time for nebulization,remaining volume of nebulized medication,and the number of tidal volume alarms from the ventilator were all significantly reduced in the observation group compared to the control group(P<0.05).The levels of partial pressure of oxygen(PaO_(2))were higher and the levels of partial pressure of carbon dioxide(PaCO_(2))were lower in both groups after nebulization treatment than before(P<0.05);1 week after treatment,the observation group showed higher PaO_(2) and lower PaCO_(2) levels than the control group(P<0.05).Conclusion Vibrating mesh nebulizers and air-compressing nebulizers can improve the indexes of blood gas analysis in the management of patients with structural lung disease complicated by respiratory failure,and the findings suggest that vibrating mesh nebulizers exert less impact on tidal volume,have higher drug utilization,and need less operation time.