热湿交换细菌过滤器联合密闭式吸痰预防呼吸机相关性肺炎  

Effects of Heat-Moisture Exchange Filters Combined with Close Endotracheal Suctioning on Prevention of Ventilator-associated Pneumonia in ICU Patients

作　　者：莫旻龙 石崛 李小悦[2] 

机构地区：[1]广西梧州市红十字会医院,广西梧州543002 [2]广东省东莞市人民医院

出　　处：《中国医学创新》2014年第10期13-15,共3页Medical Innovation of China

基　　金：梧州市科学研究与技术开发计划资助项目(201102068)

摘　　要：目的:探讨热湿交换细菌过滤器联合密闭式吸痰预防呼吸机相关性肺炎(VAP)的临床效果。方法:选取2010-2011年在本院ICU进行机械通气的158例患者,按照随机数字表法将其分成试验组80例和对照组78例。试验组采用热湿交换细菌过滤器联合密闭式吸痰,对照组采用加热湿化器联合开放吸痰。两组患者均给予化痰止咳、解痉平喘、纠正内环境紊乱、抗感染、每日2次口腔护理和床头抬高30°及营养支持等对症治疗。观察比较两组患者VAP发病率、28 d死亡率、机械通气时间和ICU住院时间的差异。结果:试验组的VAP发病率28.75%明显低于对照组的46.15%,且28 d死亡率18.75%明显低于对照组的34.62%,差异均有统计学意义(P<0.05)。试验组的机械通气时间明显少于对照组,差异有统计学意义(P<0.05),两组ICU住院时间比较差异无统计学意义(P>0.05)。结论:热湿交换细菌过滤器联合密闭式吸痰可以降低VAP发病率、28 d死亡率,缩短机械通气时间,对ICU住院时间无影响。Objective： To investigate the effects of heat-moisture exchange filters （ HMEF ） combined with close endotracheal suctioning （ CES ） on prevention of VAP in ICU patients.Method： 158 patients who were treated with mechanical ventilation in our ICU from 2010 to 2011 were selected, they were randomly divided into the experimental group for 80 cases and the control group for 78 cases, the experimental group was treated with HMEF combined with CES, the control group was treated with heated humidifying system （ HHS ） combined with open endotracheal suctioning （ OES ） . All patients Were given Huatanzhike, antispasmodic, correction of the internal environment disorder, anti infection, 2 times a day oral care and head elevation 30 % and nutritional support treatment.Incidence of VAP, 28-day mortality, the duration of mechanical ventilation and ICU stay were compared between the two groups.Result： The incidence rate of VAP in experimental group was 28.75%, it was significantly lower than the control group （ 46.15% ）, the 28 d mortality was 18.75%, it was lower than the control group （ 34.62% ）, the differences were statistically significant （ P〈0.05 ） .The duration of mechanical ventilation in experimental group was less than that of the control group, the difference was statistically significant （ P〈0.05 ） .There was no significant difference in length of stay in ICU between two groul＇s （ P〈0.05 ） .Conclusion： HMEF combined with CES can decrease incidence of VAP, 28-day mortality in ICU patients and duration of mechanical ventilation, but not decrease length of stay in ICU.

关 键 词：热湿交换细菌过滤器 密闭式吸痰 呼吸机相关性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]