联合药物气道湿化在预防新生儿呼吸机相关性肺炎中的效果观察  

Combined drug and humidification of airway in the prevention of neonatal ventilator-associated pneumonia

作　　者：吴雅秋[1] 李海珍[1] 

机构地区：[1]江苏省淮安市第二人民医院新生儿科,223002

出　　处：《中华现代护理杂志》2013年第17期2000-2002,共3页Chinese Journal of Modern Nursing

摘　　要：目的探讨在新生儿机械通气中联合应用碳酸氢钠和氨溴索进行气道湿化的效果。方法用简单随机抽样法抽取机械通气患儿52例，采用随机数字表法随机分为观察组和对照组各26例。观察组使用0．45％氯化钠加氨溴索，采用微量注射泵在不脱机的状态下进行持续气道湿化及采用碳酸氢钠进行气道冲洗；对照组按传统的方法，在脱机的状态下进行间断的气道湿化。比较两组的痰液黏稠度及呼吸机相关性肺炎（VAP）等并发症的发生率。结果观察组湿化不足率为7．7％，对照组为38．5％，两组比较，差异有统计学意义（χ2=6．93，P〈0．01）；观察组呼吸机相关性肺炎发生率为15．4％，对照组为42．3％，两组比较，差异有统计学意义（χ2=4．59，P〈0．05）。结论新生儿机械通气患儿采用氨溴索持续气道湿化并联合应用碳酸氢钠气道冲洗能有效的降低痰液黏稠度，减少呼吸机相关性肺炎的发生。Objective To investigate the effect of combined use of sodium bicarbonate and ambroxol on airway humidification in neonatal mechanical ventilation. Methods Randomly selected 52 patients with mechanical ventilation, and were randomly divided into experimental group and control group with 26 cases in each group. The experimental group used 0.45% sodium combined with ambroxol, used microinjection pump in the offline state of continuous airway humidification and the use of sodium bicarbonate for airway cleaning. While the control group used the traditional method, in an offline state of continuous airway humidification. Observed 2 groups of sputum viscosity and ventilator-associated pneumonia （VAP） and the incidence of complications. Results The experimental group patients sputum viscosity was significantly lower than that of control group , the difference was statistically significant （7.7% vs 38. 5% ; χ2 = 6. 93; P 〈 0. 01 ）. Mechanical ventilation complication rate in experimental group was significantly lower than that in control group（ 15.4% vs 42.3% ; χ2 = 4.59;P 〈 0. 05 ）. Conclusions For mechanical ventilation of the newborn with ambroxol continuous airway humidification and combined use of sodium bicarbonate and airway cleaning can effectively reduce sputum viscosity, and reduce the occurrence of ventilator-associated pneumonia.

关 键 词：肺炎  呼吸机相关性 碳酸氢钠 氨溴索 持续气道湿化 气道冲洗 

分 类 号：R473.6[医药卫生—护理学]