自控式吸引联合间断声门下吸引对建立人工气道病人医院获得性肺炎发病的影响  

Influence of self-controlled suction combined with intermittent subglottic suction on incidence of hospital acquired pneumonia in patients with artificial airway

作　　者：许瑞香[1,2] 谢书芬[2] 于玲[2] 苏婉莉[2] 

机构地区：[1]广东医学院附属开平医院 [2]广东省开平市中心医院

出　　处：《护理研究（上旬版）》2016年第3期819-822,共4页Chinese Nursing Researsh

摘　　要：[目的]探讨病人自控式吸引装置联合间断声门下吸引在建立人工气道病人中的应用效果。[方法]选择2008年7月—2014年6月我院收住的建立人工气道>48h的有自主意识的病人72例,并随机将病人分为3组:对照A组21例,采用持续引流;对照B组23例,采用间断引流;观察组28例,采用自控式吸引管理系统联合间断引流。观察3组病人在建立人工气道15d内病原微生物检验结果、每天引流量、气道需要开放时间、医院获得性肺炎(HAP)发生率及总住院时间。[结果]观察组建立人工气道后每天引流量明显少于对照A组、B组病人(P<0.01);观察组建立人工气道后15d内HAP发生率明显低于对照A组、B组病人(P<0.01);观察组需要气道开放时间、总住院时间较对照A组、B组短,差异有统计学意义(P<0.01);3组致病菌分布均以铜绿假单胞菌居首位(31.18%),其次为鲍曼不动杆菌(27.96%)、肺炎克雷伯菌(18.28%);观察组病人耐受性、依从性均较好,在观察期间未发现特殊并发症发生;对照A组中有4例病人发生少量出血,对症处理后缓解。[结论]在需建立人工气道的有自主意识的病人采用自控式吸引联合间断声门下吸引是安全有效的。Objective：To probe into the application effect of self-controlled suction combined with intermittent subglottic suction in patients with artificial airway.Methods：A total of 72 independent consciousness inpatients with artificial airway 〉48h in our hospital from July 2008 to June 2014 were selected,they were randomly divided into three groups：the 21 cases of A control group received the continuous drainage;23cases of B control group received the intermittent drainage;while the 28 cases of observation group received the self-controlled suction management system combined with intermittent drainage.The patients of three groups were observed on the pathogenic microbial test results,daily lead flux,needful open time of airway,incidence of hospital acquired pneumonia（HAP）and total length of stay in hospital within 15 days after establishment of artificial airway.Results：The daily lead flux of observation group after the establishment of artificial airway was significantly less than that of the control A and B groups（P〈0.01）;the incidence of hospital acquired pneumonia in the observation group within 15 days after establishment of artificial airway was significantly lower than that of the control A and B groups（P〈0.01）;the needful open time of airway and total length of stay in hospital in observation group were shorter than those of the control A and B groups（P〈0.01）.The distribution of pathogens in the 3groups was that the Pseudomonas aeruginosa was in the first place（31.2%）,followed by Bauman Acinetobacter（27.9%）and Klebsiella pneumoniae（18.2%）.The observation group had better tolerated,compliance,and no special complications occurred during the observation period,while 4patients in the control group had a small amount of bleeding,which relieved after the symptomatic treatment.Conclusion：It was safe and effective to use self-controlled suction combined with intermittent subglottic suction in the independent consciousness patients who need to establish artificial airway.

关 键 词：人工气道 自控式吸引 间断声门下吸引 医院获得性肺炎 病原微生物检测 

分 类 号：R473.5[医药卫生—护理学]