锥形气囊气管导管预防颅脑损伤患者呼吸机相关肺炎的效果分析  

作　　者：丁秀娟 王金柱[1] 吴文静[1] 陈娟红[1] 姚惠萍[1] 

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院),310014

出　　处：《浙江临床医学》2020年第1期41-43,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省教育厅一般科研项目(Y201534508);浙江省医药卫生一般研究计划(2015KYB014)。

摘　　要：目的探讨锥形气囊气管导管预防颅脑损伤患者呼吸机相关肺炎(VAP)的临床效果.方法选择因呼吸衰竭接受气管插管的颅脑损伤患者110例,随机分为对照组和观察组,每组各55例.所有患者均接受呼吸机辅助通气治疗,对照组患者采用传统圆形气囊气管套管,观察组采用新型锥形气囊气管套管.气管插管期间两组患者均实施VAP集束化护理方法.比较两组患者VAP发生情况、痰液变化量、声门下分泌物变化量、临床肺部感染评分(CPIS)、机械通气时间、ICU停留时间及住院费用差异.结果观察组患者VAP发生率及平均诊断VAP时间均明显低于对照组,差异有统计学意义(P<0.05).观察组患者痰液和声门下分泌物比对照组明显减少,第7天时,观察组CPIS明显低于对照组,且机械通气时间、ICU停留时间及ICU住院费用均明显短于对照组,差异均有统计学意义(P<0.05).结论锥形气囊气管导管能够明显减少声门下分泌物及误吸,降低VAP的发生率,缩短机械通气时间并减少ICU停留时间,值得在临床中推广应用.Objective To discuss the effect of tapered cuff endotracheal tubes to prevent the occurrence ventilator-associated pneumonia(VAP)in patients with craniocerebral injury.Methods A total of 110 patients with craniocerebral injury were selected as research object and divided into the control group(n=55)and observation group(n=55).All cases were given intubation of the breath tube and ventilation,the patients of control group were given cylindrical cuff endotracheal tubes while the patients of observation group were given tapered cuff endotracheal tubes.All people were given VAP cluster bundled nursing measures.The occurrence dynamics of VAP,sputum volume changes,subglottic secretion changes,clinical pulmonary infection score(CPIS),mechanical ventilation duration,duration of ICU stay and hospitalization expenses of the two groups were compared.Results The occurrence rate and average diagnostic time of VAP of the observation group were all lower than that of the control group,differences were statistically significant(all P<0.05).The sputum volume changes,subglottic secretion changes and the CPIS of 7th day after admission of the observation group increased obviously,while the mechanical ventilation duration,duration of ICU stay and hospitalization expenses decreased than that of the control group,differences were statistically significant(all P<0.05).Conclusion The tapered cuff endotracheal tubes can deduce the subglottic secretion and aspiration and the occurrence of VAP.It can shorten mechanical ventilation time and ICU residence time,it is worth popularizing in clinical application.

关 键 词：颅脑损伤 锥形气囊气管套管 机械通气 呼吸机相关肺炎 

分 类 号：R47[医药卫生—护理学]