呼吸器辅助声门下分泌物引流导管对机械通气时气囊滞留物清除的临床研究  

A clinical study of SSD catheter with associated-respirator on cleaning retentate of air sac during MV

作　　者：王爱贞[1] 郑兰华[1] 王秀[2] 魏静 WANG Ai-zhen;ZHENG Lan-hua;WANG Xiu(Emergency Department,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院急诊科,内蒙古呼和浩特010050 [2]内蒙古医科大学附属医院麻醉科,内蒙古呼和浩特010050

出　　处：《中国医学装备》2020年第3期96-99,共4页China Medical Equipment

摘　　要：目的:探讨简易呼吸器辅助声门下分泌物引流(SSD)导管对接受机械通气(MV)患者行气囊滞留物清除的临床效果。方法:选取在医院治疗的84例经口气管插管应用MV治疗的患者资料,采用随机数表法将其分为观察组和对照组,每组42例。两组呼吸机治疗时均执行常规人工气道标准管理;对照组使用SSD导管,以76~113 mmHg负压值行SSD法间歇性吸引;观察组除采用SSD法行间断声门下吸引外,将简易呼吸器与患者的气管插管相连,加用气流冲击法,以加大气囊上滞留物的清除效果。比较两组每日声门下分泌物吸引总量、MV治疗时间及入住重症监护室(ICU)天数,评估两组不同气囊管理模式下对呼吸机相关性肺炎(VAP)的影响。结果:观察组声门下滞留物总吸引量增加,与对照组比较差异有统计学意义(t=-7.143,P<0.05);观察组MV治疗时间和入住ICU天数均低于对照组,其差异均有统计学意义(t=-4.075,t=-8.291;P<0.05);观察组VAP发生率为9.52%(4/42),对照组VAP发生率为14.28%(6/42),两组比较差异有统计学意义(χ^2=3.971,P<0.05)。结论:在提供有效SSD法间断声门下吸引的基础上联合简易呼吸器气流冲击法,可有效提高机械通气患者气囊上滞留物清除效果,对预防控制VAP发生具有重要临床意义。Objective:To investigate the clinical effect of subglottic secretions drainage(SSD)catheter with simply associated-respirator for patients who received mechanical ventilation(MV)and underwent cleaning retentate of air sac.Methods:The data of 84 patients who received MV treatment by endotracheal intubation were selected and they were randomly divided into observation group and control group,with 42 cases in each group.Routine manual airway standard management was performed in both groups during treatment with ventilator.SSD catheter was used in control group,and SSD intermittent suction was performed as negative pressure of 76~113mmHg in control group.In observation group,in addition to the method of control group,the simple respirator was connected to endotracheal intubation of patients,and airflow shock method was added to enhance the removal effect of retentate on the air sac.The total volume of daily subglottic secretion,MV treatment time and ICU admission days between the two groups were compared,and the effects of different management mode of air sac of two groups for ventilator-associated pneumonia(VAP)were assessed.Results:The difference of total volume of subglottic secretion between the two groups was significant(t=-7.143,P<0.05).The MV treatment time and ICU admission days of observation group were significantly lower than those of control group(t=-4.075,t=-8.291,P<0.05),respectively.The incidence of VAP of observation group was 9.52%(4/42),and that was 14.28%(6/42)in control group.The difference of that between two groups was statistically significant(χ^2=3.971,P<0.05).Conclusion:The method that combines with simple respirator airflow shock method on the basis of providing effective SSD method of intermittent subglottic suction can effectively improve the removal effect of retentate on air sac of patients who undergo MV.It has important clinical significance in preventing and controlling the occurrence of VAP.

关 键 词：简易呼吸器 声门下分泌物引流(SSD) 导管 气囊滞留物 

分 类 号：R563.1[医药卫生—呼吸系统]