人工气道进口端不同湿化温度对湿化效果的影响  

Effects of different inlet temperature on humidity during invasive mechanical ventilation

作　　者：王芳[1] 董元伟[1] 吴晓蓉[1] 

机构地区：[1]上海交通大学医学院附属仁济医院急诊监护室,上海200127

出　　处：《临床荟萃》2014年第7期758-760,共3页Clinical Focus

基　　金：上海交通大学医学院立项课题(Jyh1209)

摘　　要：目的研究监护室经口有创机械辅助通气患者进口端不同湿化温度对湿化效果的影响。方法对入选患者进行随机分组,分成A、B、C 3组。A组：控制进口端温度32～33.9℃;B组：控制进口端温度34～35.9℃;C组：控制进口端温度36～37℃。按此规律对湿化器进行调整,并持续监测进口端温度、绝对湿度,整套设备运行稳定后开始记录进口端温、湿度,同时记录患者痰液黏稠度、肺部听诊呼吸音、刺激性咳嗽次数、痰痂形成、总带管时间以及呼吸机相关性肺炎（VAP）发生率。结果①与A、B组比较,C组患者的痰液黏稠度降低,无痰痂形成,刺激性咳嗽次数明显少（P〈0.05）;②C组患者较A、B组,平均总带管时间相对减少,VAP发生率显著降低（P〈0.05）。结论将有创机械辅助通气患者人工气道进口段温度控制在36℃～37℃,有利于患者及早撤机,减少患者气道损伤,降低VAP的发生率。Objective To explore humidity effect at different inlet temperature and absolute humidity during invasive mechanical ventilation.Methods Patients were randomly divided into three groups.The inlet temperature was between 32-33.9℃（group A）,The inlet temperature 34-35.9℃（group B）,the inlet temperature 36-37℃（group C）.When the whole equipment adjusted stabilitibly,inlet temperature,humidity,patients＇ sputum viscosity,breath sounds,irritating cough,sputum scab,days of respirator application,and the incidence of ventilator associated pneumonia（VAP）were recorded.Results ①Compared with group A or B,patients in group C had less irritating cough,no sputum scab（P 〈0.05）;②compared with group A or B,patients in group C had less average days of respirator application,and the incidence of VAP was significantly decreased（P〈0.05）.Conclusion It is beneficial to remove the ventilator as soon as possible,which can reduce airway injury and decrease the incidence of VAP by controlling the inlet temperature between 36-37℃.

关 键 词：呼吸 人工 湿化 插管 

分 类 号：R675.973[医药卫生—外科学]