气流冲击法清除气囊上滞留物对经口气管插管患者预防呼吸机相关性肺炎的效果评价

Effect evaluation of preventing ventilator associated pneumoia of patients with the oral trachea can-nula by air impact method to remove airbags retentate

目的 观察经口气管插管患者采用气流冲击法清除气囊上滞留物对呼吸机相关性肺炎(VAP)发生率的影响. 方法 选择我院重症医学科348例经口气管插管并进行机械通气的患者,按入院顺序随机分成对照组和观察组各174例患者. 对照组采用常规的气道管理方法,未对其进行声门下分泌物引流,观察组采用在常规气道管理方法的基础上结合气流冲击法清除气囊上滞留物的方法. 所有患者其他治疗与护理基本相同. 比较2组患者的机械通气时间、重症监护病房(ICU)时间及VAP的发生率. 结果 观察组的机械通气时间为(5.25±1.18) d、入住ICU时间为(5.62±3.20)d、VAP的发生率为10.34%(18/174),对照组则分别为(8.96±5.43) d、(10.43±4.96) d、34.48%(60/174),2组比较差异均有统计学意义,均P<0.05. 结论 对经口气管插管患者行气流冲击法清除气囊上滞留物可以缩短患者的机械通气时间及ICU住院时间,并减少VAP的发生.

Objective To evaluate effect of preventing ventilator associated pneumoia (VAP) of patients with oral cavity endotracheal intubation by air impulse clearing away secretion drainage. Methods 348 patients with oral trachea cannula and mechanical ventilation (MV) in intensive care unit (ICU) were divided into control group (n=174) and observational group (n=174). The control group adopted conventional airway management methods without the subglottic secretion drainage while the observational group adopted conventional airway management methods on the basis of combining air impact method remove stranded on airbags. Other treatment and care for all of patients were basically the same. The MV time, duration in ICU and incident rate on VAP were compared between the two groups. Results The average of MV time in control group was (5.25±1.18) days, (5.62±3.20) days in ICU and the rate of VAP was 10.34%(18/174). In observational, it was (8.96 ±5.43) days, (10.43 ±4.96 ) days and 34.48%(60/174), respectively. The MV time, duration in ICU and incident rate on VAP were significantly different (P<0.05), with statistical significance. Conclusions The air impact method to remove airbags retentate could shorten time of MV and during time in ICU, and could reduce the rate of VAP.