呼吸机内部回路消毒预防呼吸机相关肺炎的效果观察  

The effects of the disinfection of internal circuit of ventilator in prevent the incidence of ventilator associated pneumonia

作　　者：杨龙[1] 王芝静[2] 崔莹[1] 贾汝福[3] YANG Long;WANG Zhijing;CUI Ying(Department of Emergency,EncephalopathyBranch of Cangzhou Central Hospital,Hebei,Cangzhou 061000,China;不详)

机构地区：[1]河北省沧州市中心医院脑科院区急诊科,061000 [2]河北省沧州市中心医院脑科院区麻醉科,061000 [3]河北省沧州市中心医院脑科院区护理部,061000

出　　处：《河北医药》2021年第1期98-100,104,共4页Hebei Medical Journal

基　　金：吴阶平医学基金项目(编号:320.6750.16050)。

摘　　要：目的评价呼吸机内部回路消毒在预防呼吸机相关肺炎(VAP)发生中的临床效果。方法选择2018年1~12月使用有创机械通气的患者200例,按照随机数字方法分为观察组和对照组,每组100例。2组患者均在采用一致的组合干预措施基础上,观察组在机械通气前,呼吸机均经呼吸机内部回路消毒机消毒。机械通气7 d后,依据呼吸机呼气端与患者下呼吸道检出细菌的种类及数目,统计其细菌一致性。通过呼吸机呼气端与吸气端细菌培养菌落数,评价呼吸机内部回路消毒机的消毒效果。同时,依据VAP诊断标准计算2组患者VAP的发生率。结果呼吸机呼气端与患者下呼吸道细菌菌落数存在高度的一致性(kappa系数0.478~1)。呼吸机消毒后细菌菌落数与消毒前相比明显下降,差异有统计学意义(P<0.01)。观察组与对照组相比,VAP发生率明显下降,差异有统计学意义(P<0.05)。结论呼吸机呼气端与患者下呼吸道细菌培养存在高度的一致性,呼吸机内部回路消毒机对呼吸机内部回路消毒效果明显,使用呼吸机内部回路消毒后的呼吸机能够明显减少VAP的发生。Objective To investigate the effects of the disinfection of internal circuit of ventilator in prevent the incidence of ventilator associated pneumonia(VAP).Methods A total of 200 patients who were treated by invasive mechanical ventilation in our hospital from January to December in 2018 were enrolled in the study,who were randomly divided into observation group and control group,with 100 patients in each group.The patients in both groups were treated by comprehensive intervention measures,moreover,the patients in observation group were treated by ventilators in which the internal circuit was disinfected before mechanical ventilation,however,the patients in control group were were treated by ventilators in which the internal circuit was not disinfected before mechanical ventilation.The disinfection effects of the internal circuit ventilator disinfection machine was evaluated according to the number of colonies cultured at the expiratory end and the inspiratory end of the ventilator.Moreover the incidence rate of VAP was observed and compared between the two groups.Results There was a close consistency between the expiratory end of the ventilator and the level of bacterial colonies in the lower respiratory tract of the patient(kappa coefficient:0.478~1).The average numbers of bacterial colony after the ventilator was disinfected were significantly lower than those before disinfection(P<0.01).Moreover the incidence rate of VAP in observation group was significantly lower than that in control group(P<0.05).Conclusion The end expiratory of the ventilator has a close consistency with bacterial culture in the lower respiratory tract of patient.The internal disinfection machine of the ventilator has obvious disinfective effects on the internal circuit of ventilator,which can significantly decrease the incidence rate of VAP.

关 键 词：呼吸机 内部回路消毒 呼吸机相关肺炎 

分 类 号：R563.19[医药卫生—呼吸系统]