吸痰前气道内注射0．9％氯化钠溶液对机械通气患者的影响  

Effect of 0.9 % sodium chloride solution airway instillation before endotracheai suctioning on machinery ventilates patients

作　　者：王玉容[1] 沈耀红[1] 徐瑾[1] 陈大伟[1] 应佑国[1] 方玉明[1] 秦宗和[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院ICU,201900

出　　处：《中华现代护理杂志》2012年第21期2578-2581,共4页Chinese Journal of Modern Nursing

摘　　要：目的探讨吸痰前气道内注射0．9％氯化钠溶液对机械通气患者各方面的影响。方法选取ICU机械通气超过72h的患者80例，随机分为实验组与对照组各40例，实验组患者吸痰前气道内注射0．9％氯化钠溶液5ml，对照组不注射0．9％氯化钠溶液，观察比较两组患者呼吸机相关性肺炎（VAP）发生率、痰培养阳性率、机械通气时间及ICU入住时间。结果实验组患者VAP发生率为25．0％，对照组为15．0％，两组比较，差异无统计学意义（P〉0．05）；实验组患者痰培养阳性率为47．5％，高于对照组的22．5％，差异有统计学意义（X2=5．495，P〈0．05）；实验组患者机械通气时间及ICU入住时间分别为（7．35±3．89），（10．88±4．37）d，均高于对照组的（5．73±2．45），（9．00±3．59）d，差异均有统计学意义（U分别为602．0，589．5；P〈0．05）。结论吸痰前气道内注射0．9％氯化钠溶液可提高痰培养阳性率，增加患者机械通气时间及ICU入住时间，不应该作为常规护理措施。Objective To explore the effect of 0.9% sodium chloride solution airway instillation before endotracheal suctioning on machinery ventilates patients. Methods Totals of 80 patients who received mechanical ventilation longer than 72 hours were enrolled in this study and were randomly divided into experimental group and the control group with 40 cases each group. And 5ml 0.9% sodium chloride solution was instilled into the airway of each case in experimental group before the endotracheal suctioning, while the same procedure was not performed in control group. The incidence of VAP, the positive rate of sputum culturing, the mechanical ventilation time and the staying time in ICU were observed and respectively compared between the two groups. Results The incidence of VAP was 25.0% in experimental group and 15.0% in control group, and the difference was no statistically significance（ P 〉 0.05）. The positive rate of sputum culturing was 47.5% in experimental group, while that was 22.5% in control group, and the difference was statistically significant（ ~5 = 5. 495, P 〈 0. 05 ）. The mechanical ventilation time and the staying time in ICU of experimental group respectively were higher than that of control group [ （ 7.35 ± 3.89 ） vs （ 5.73± 2.45 ）, （ 10.88 ± 4.37 ） vs （ 9.00 ± 3.59 ） ], and the difference was statistically significant （ U = 602.0,589.5, respectively ; P 〈 0.05 ）. Conclusions Airway instillation of 0.9% sodium chloride solution before endotracheal suctioning can increase the positive rate of sputum culturing, mechanical ventilation time, and the staying time in ICU for patients, so it should not be performed as a routine nursing procedure.

关 键 词：肺炎 呼吸机相关性 吸痰 0.9%氯化钠溶液 机械通气 

分 类 号：R472[医药卫生—护理学]