气管切开导管气囊上滞留物持续引流及定期冲洗对危重病人医院获得性肺炎发病的影响  

The effect of continuous drainage and regular flushing of the subglottic secretion on morbility of hospital acquired pneumonia

作　　者：秦志梅[1] 叶芷彤[1] 

机构地区：[1]东莞东华医院ICU,广东东莞523110

出　　处：《临床和实验医学杂志》2009年第7期29-31,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察气囊上滞留物持续引流及定期冲洗对医院获得性肺炎(HAP)发病的影响。方法选我院重症监护室(ICU)2005年1月至2008年6月气管切开危重病人83例,将其随机分为两组。A组:气囊上滞留物持续引流组42例;B组:气囊上滞留物定期冲洗组41例。分别记录气管切开气道开放时间、发生HAP的时间、ICU住院天数,定期对口咽部气囊上滞留物和下呼吸道分泌物进行细菌学检测,记录患者每日吸痰量,气囊上滞留物的引流量和发生HAP的病例数。结果B组HAP发生率(34.0%)低于A组(60.0%),气囊上滞留物与下呼吸道病原体有一致性和相似的构成比。结论气囊上滞留物引流定期冲洗可以降低ICU气管切开危重病人院内感染肺炎发生率,减少气道开放时间,相应地也减少ICU的住院时间、总住院时间和住院费用,降低病死率。Objective To investigate the effect of continuous drainage and regular flushing of the subglottic secretion on morbility of hospital acquired pneumonia （HAP）. Methods Eighty - three cases of critical patients with tracheotomy from January 2005 to June 2008 in our ICU were selected and divided randomly into two groups： 42 cases of continuous drainage of the subglottie secretion （group A） and 41 cases of regalar flushing of the subglottie secretion （ group B）. The trachea opening time, the beginning time and staying time in ICU of HAP were respectively recorded. The bacteriological detection of oropharyngeal subglottic secretion and the lower respiration secretion were regularly conducted. And the daily amount of phlegm, the amount of the subglottic secretion drainage and cases of HAP sufferers were recorded. Results Group B （ 34.0% ） showed a lower incidence rate of HAP compared with group A （60.0%）. Pathogens found in subglottic secretion drainage were similar to those found in lower respiratory secretion. Conclusion Regular flushing of the subglottic secretion may decrease the incidence rate of HAP in intensive care patients underwent tracheostomy, also reduce trachea opening time, ICU staying time, hospitalization time, cost and mortality rate.

关 键 词：气管切开 气囊上滞留物持续引流 气囊上滞留物定期冲洗 医院获得性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统] R651.1[医药卫生—内科学]