试脱机患者呼吸机管路更换周期的实验性研究  

Experimental study of the pipe replacement cycle for the suspension of ventilator

作　　者：初静[1] 王鹤[1] 王颖[1] 

机构地区：[1]山东省烟台毓璜顶医院重症医学科,264000

出　　处：《中国实用护理杂志》2015年第23期1733-1736,共4页Chinese Journal of Practical Nursing

摘　　要：目的通过对机械通气患者呼吸机相关性肺炎（VAP）发生率及呼吸机管路病原菌检测结果的对比，探讨试脱机患者再次行机械通气时是否需要更换呼吸机管路。方法选取我院使用呼吸机行机械通气超过48h、试脱机时间（48±4）h需再次行机械通气的69例患者，按上、下半月入住时间分为2组，A组为需要再次机械通气时更换新的呼吸机管路，B组使用原管路。分别于试脱机时、再次机械通气后连续4d每天采集呼吸机管路出气口标本进行细菌培养计数，观测患者试脱机时、再次机械通气后2、12、24h及2、3、4d的体温、白细胞总数、中性粒细胞比例等指标；比较2组患者VAP的发生率。结果再次机械通气后4d2组体温[A组（38．5±1．6）℃，B组（38．4±2．0）℃]、白细胞总数[A组（11．8±3．5）×109．／L，B组（12．1±3．7）×109／L】、中性粒细胞比例【A组（0．85±0．16），B组（0．84±0．20）】等指标变化差异无统计学意义，均P〉0．05；2组VAP发生率[A组37．1％（13／35），B组35．3％（12／34）]，差异无统计学意义，P〉0．05。结论呼吸机管路在其使用7d的周期内，患者试脱机后再次机械通气时无需更换呼吸机管路。Objective To compare the detection results by bacteria pathogenic rate of ventilator- associated pneumonia （VAP） pipeline and ventilator patients with mechanical ventilation, to investigate whether need to replace the ventilator weaning patients underwent another test of pipeline during mechanical ventilation. Methods This study selected using the ventilation mechanical ventilation for more than 48 hours, try （48 ± 4） hours required to mechanical ventilation in 69 patients. They were divided into two groups according to admission time, group A was in need of replacement ventilation pipeline of new again during mechanical ventilation, group B used the original pipeline.In offline, try again during mechanical ventilation after mechanical ventilation, once daily for d days to collect ventilator pipe air outlet samples for bacterial culture counts were observed, while offline, use again after 2 hours, 12 hours of ventilator, 24 hours, 2 days, 3 days, 4 days of body temperature, white blood cell count, neutrophil classification and other indicators. The incidence of VAP was compared between two groups. Results The temperature, white blood cell count, neutrophil classification were （38.5 ±1.6）℃, （11.8 ±- 3.5）×109/L, 0.85±0.16 in group A, while （38.4 ±_ 2.0） ℃, （12.1 ±_ 3.7）×109/L, 0.84 ±_ 0.20 in group B, and there were no significant differences between two groups, P〉0.05. The incidence of VAP was 37.1%（13/35） and 35.3%（12/34） in group A and group B, and there was no significant difference, P〉 0.05. Conclusion There is no necessary for trial offline patients without respiratory infection to change the ventilator pipe when to re-ventilate during the 7 days using period of the ventilator pile.

关 键 词：肺炎 呼吸机相关性 试脱机 呼吸机管路 病原菌 

分 类 号：R473[医药卫生—护理学]