气管切开气道湿化给药对气管粘膜纤毛损伤的研究  

Study on the impairment of trachea mucosa cilia caused by trachea humidifying drug administration after tracheotomy

作　　者：杨敏[1] 周君富[1] 夏秋欣[1] 陈唯唯[1] 卢华苹[1] 王华林[1] 何建国[1] 施水娟[1] 

机构地区：[1]浙江大学医学院附属第二医院,浙江杭州310009

出　　处：《护士进修杂志》2002年第10期727-729,共3页Journal of Nurses Training

基　　金：浙江大学医学院附属第二医院 2 0 0 0年院级科研基金资助

摘　　要：目的探讨气管切开气道湿化给药对气管粘膜纤毛的影响。方法使用不同浓度的硫酸庆大霉素 生理盐水溶液给气管造口后的家兔进行气管滴药 ,在用药的第 7天和第 1 4天取其气管粘膜进行扫描电镜观察 ,同时以生理盐水作对照。结果用药第 7天即有不同程度的气管粘膜纤毛损伤性改变 ,表现为纤毛脱落、缺失、断裂、方向混乱、倒伏、变短和参差不齐 ,其气管粘膜纤毛受损面积显著大于生理盐水组 ;用药第 1 4天 ,气管粘膜纤毛损伤加剧 ,表现为部分区域纤毛大片脱落 ,其气管粘膜纤毛受损面积也显著大于生理盐水组。结论使用传统的气道湿化液———庆大霉素加生理盐水 ,对气管粘膜纤毛会造成不同程度的损伤 ,破坏气管粘膜上皮表面粘液纤毛清除功能 ,从而造成痰液潴留 。Objective To study on the effect of the post tracheotomy air passage humidifying medication damaging to the tracheal mucosa cilia.Method Different concentration of gentamicin saline solution were used to humidifying air passage of post tracheotomy rabbits, on the 7 th days and the 14 th days, the rabbits' tracheal mucosa cilia shape were observed with scanning through an electron microscope. At the same time, the normal saline solution was used as control.Result Damaging changes of tracheal mucosa cilia shape at different degree were founded on the 7 th day, such as losing,lacking,breaking and so on. And the damage area of the tracheal mucosa cilia was greater significantly than that of the normal saline solution group. the damaged areas of tracheal mucosa cilia shape was aggravated on the 14 th day, and the danaged areas of the tracheal mucosa cilia was greater significantly than that of the normal saline solution group too.Conclusion The traditional air passage humidifying solution such as gentamicin normal saline solutions could damage the tracheal mucosa cilia at the some degree, and destroy the tracheal mucosa ciliary transport cleaning function, thus leading to obstruction of secretion like sputum and farther obstructing airpassage.

关 键 词：气管切开 气道湿化给药 气管粘膜 纤毛损伤 研究 

分 类 号：R605.973[医药卫生—急诊医学]