气囊上滞留物引流对呼吸机相关性肺炎的影响及致病菌分析  

Effect of subglottic secretion drainage on ventilator associated pneumonia and analysis of pathogenic bacterium

作　　者：杜志强[1] 施青山[1] 李凤诗 

机构地区：[1]江苏省连云港市第二人民医院,222006

出　　处：《检验医学与临床》2014年第4期465-467,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨人工气道机械通气患者气囊上滞留物引流对呼吸机相关性肺炎(VAP)及致病菌的影响。方法将2011年3月至2012年9月于本院重症监护病房(ICU)建立人工气道,且机械通气超过72h的患者106例随机分为气囊上滞留物引流组(实验组)56例和非引流组(对照组)50例,记录VAP发生时间、气道开放时间、ICU住院时间、总住院时间,不同类型标本病原学培养、鉴定结果及患者病死率等。结果实验组患者VAP发病率、气道开放时间、ICU住院时间、总住院时间、病死率等明显低于对照组(P<0.05);下呼吸道痰液标本病原学培养结果与气囊上滞留物培养结果一致。结论气囊上滞留物引流可以明显降低ICU人工气道机械通气患者VAP发病率,缩短气道开放时间、ICU住院时间及总住院时间,降低病死率;清除气囊上滞留物可减少气囊上致病菌侵入下呼吸道,避免下呼吸道感染的发生,是预防VAP的有效方法。Objective To explore the influence of subglottic secretion drainage （SSD）on ventilator associated pneumonia （VAP）and pathogenic bacteria in patients treated by mechanical ventilation （MV）.Methods From Mar. 2010 to Sep.2012,106 patients,treated by MV for more than 72 hours in Intensive Care Unit （ICU）,were randomly divided into SSD group （experiment group,n=56）and non-SSD group （control group,n=50）.Clinical data,such as onset time of VAP,duration of MV,length of stay in ICU,etiology culture results and the mortality were recorded. Results The incidence of VAP,duration of MV,length of stay in ICU and the mortality in experiment group were lower than control group （P＆lt;0.05）.Etiology culture results of SSD were similar to lower respiratory secretion.Con-clusion SSD could reduce the incidence rate of VAP,trachea opening time,length of stay in ICU,hospitalization time and mortality rate.SSD could also avoid the infection of lower respiratory tract via inhibiting bacterial motility.SSD might be an effective method for the prevention of VAP.

关 键 词：人工气道 机械通气 气囊上滞留物引流 呼吸机相关性肺炎 致病菌 

分 类 号：R563.1[医药卫生—呼吸系统]