不同间断控制气管导管套囊压力时间对呼吸机相关性肺炎发生的影响  

Effect of artificial airway cuff pressure at different monitoring intervals on ventilator associated pneumonia in critical patients

作　　者：郭晓伟[1] 刘志敏[1] 龚秀琴[1] 徐星欣 段培蓓[1] Guo Xiaowei Liu Zhimin Gong Xiuqin Xu Xingxin Duan Peibei(Jiangsu Provincial TCM Hospital, Nanjing University of Chinese Medicine, Nanjing, 210019, China)

机构地区：[1]南京中医药大学附属江苏省中医院,江苏南京210029

出　　处：《现代临床护理》2017年第6期22-25,共4页Modern Clinical Nursing

摘　　要：目的探讨不同间断控制气管导管套囊压力时间对呼吸机相关性肺炎(ventilator associated pneumonia,VAP)发生的影响。方法选取2015年1月至12月在本院ICU收治行气管插管机械通气的患者56例,按病区分组,将本院南院病区32例患者设为观察组,将本院北院病区24例患者设为对照组。两组患者均给予相同的气管插管机械通气常规护理,观察组患者每6 h间断控制套囊压力至30 cm H_2O,对照组患者每4 h间断控制套囊压力至30 cm H_2O。比较两组患者气管插管机械通气期间VAP发生率、VAP发生时间、机械通气持续时间、死亡率。结果两组患者气管插管机械通气期间VAP发生率、VAP发生时间、机械通气时间和死亡率比较,差异无统计学意义(P>0.05)。结论对于气管插管机械通气期患者选择每6 h间断控制气管导管套囊压力至30 cm H_2O,对VAP的发生、机械通气时间及死亡率无影响,且可减少护理人员的工作量。Objective To investigate the effects of artificial airway cuff pressure at different monitoring intervals on ventilator associated pneumonia （VAP） in critical patients. Methods About 56 patients treated with mechanical ventilation from January 2015 to December were grouped by ward numbers 32 patients in the south ward were in the experiment group and 24 in the north ward were in the control group. The two groups were given the same routine care, e.g., mechanical ventilation by endotracheal intubation. In the experiment group, the cuff pressure was controlled to 30cm H20 every six hours and the control group was every 4h. The two groups were compared in terms of the incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation and mortality. Result The incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation, and mortality showed no significant differences between the two groups （P 〉0.05）. Conclusions For mechanically ventilated patients, the cuff pressure controlled to 30cm H20 every 6h can not increase the incidence of VAP, duration of mechanical ventilation and mortality. It can reduce the nursing workload.

关 键 词：呼吸机相关性肺炎 气管插管 机械通气 

分 类 号：R473.5[医药卫生—护理学]