可冲洗式声门下吸引对机械通气患者呼吸机相关性肺炎发生率的影响  

Influence of washable type subglottic attract on incidence of ventilator - associated pneumonia in patients with mechanical ventilation

作　　者：董申琴[1] 邵小青[1] 靳春艳[1] 孙荣[1] 张广艳[1] 吴晓琴[1] 

机构地区：[1]徐州医学院第二附属医院,221006

出　　处：《中国实用护理杂志》2012年第7期22-25,共4页Chinese Journal of Practical Nursing

基　　金：基金项目：徐州市财政局资助项目【徐财工贸（2010）11号】;徐州市科学技术局资助项目[徐科计（2010）137号]

摘　　要：目的探讨可冲洗式间歇声门下吸引对机械通气患者呼吸机相关性肺炎发生率的影响。方法选取2009年7月至2010年7月收治的需进行机械通气的患者356例作为研究对象。将其随机分为观察组和对照组各178例。对照组患者采用常规气管导管进行机械通气，观察组患者采用可冲洗式间歇声门下吸引气管导管进行机械通气。比较2组患者在机械通气过程中呼吸机相关性肺炎的发生率。并对气囊上滞留物进行目标性监测、病原学检查和药物敏感试验，并对细菌的构成、耐药性进行分析。结果2组患者在机械通气期间呼吸机相关性肺炎的发生率比较，观察组明显低于对照组。气囊滞留物共检出186株菌株，下呼吸道共检出169株菌株。结论可冲洗式声门下吸引能明显降低机械通气患者并发呼吸机相关性肺炎的概率，值得临床推广应用。Objective To explore the influence of washable type subglottic attract on incidence of ventilator-associated pneumonia （VAP） in patients with mechanical ventilation. Methods 356 cases in need of mechanical ventilation from July 2009 to July 2010 in our hospital were chosen as the research object. They were randomly divided into the observation group and the control group with 178 cases in each group. The control group was treated with conventional endotracheal tube for mechanical ventilation. The observation group used washable type subglottic endotracheal tube to attract for mechanical ventilation. The VAP rate for the two groups occurred during mechanical ventilation in ventilator was compared. Migration of the dominant bacteria of the subglottic secretion was detected, underwent pathogenic examination and drug sensitivity test. Results The VAP rate was significantly lower in the observation group than that of the control group. 186 bacteria strains were detected from subglottic secretion, and 169 were detected from lower respiratory tract. Conclusions Washable type subglottic attract for mechanical ventilation can reduce the risk of ventilator-associated pneumonia for patients with mechanical ventilation significantly, and it is worthy of clinical application.

关 键 词：可冲洗式间歇声门下吸引 机械通气 呼吸机相关性肺炎 病原菌 改善效果 

分 类 号：R563.1[医药卫生—呼吸系统]