不同吸痰方式对行机械通气慢性阻塞性肺疾病患者发生呼吸机相关肺部感染的影响  

Effects of different sputum suctioning approaches on incident ventilator-associated pulmonary infection inpatients with chronic obstructive pulmonary disease undergoing mechanical ventilation

作　　者：王振玲[1] 赖晓全[1] 徐敏[1] 熊薇[1] 魏诗晴[1] WANG Zhen-ling;LAI Xiao-quan;XU Min;XIONG Wei;WEI Shi-qing(Department of Infection Management,Tongji Hospital,Tongji Medical College of Huangzhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院感染管理科,湖北省武汉市430030

出　　处：《广西医学》2021年第1期1-3,39,共4页Guangxi Medical Journal

基　　金：国家自然科学基金(71473098)。

摘　　要：目的比较不同吸痰方式对行机械通气慢性阻塞性肺疾病(COPD)患者发生呼吸机相关肺部感染的影响。方法将80例行机械通气的COPD患者,随机分为观察组和对照组,每组40例,观察组采用密闭式气管内吸痰,对照组采用开放式气管内吸痰,比较两组患者呼吸机相关性肺炎(VAP)的发生率、机械通气时间、住院时间、临床肺部感染评分(CPIS),以及插管后24 h、48 h、72 h及拔管时的细菌检出率。结果观察组患者VAP发生率低于对照组,机械通气时间及住院时间均短于对照组,插管后第3、5、7天观察组患者CPIS评分均低于对照组(P<0.05),插管后48 h、72 h及拔管时细菌检出率均低于对照组(P<0.05)。结论COPD患者机械通气过程中,采用密闭式吸痰法能有效降低VAP的发生率,减少了机械通气时间及住院时间。Objective To compare the effects of different sputum suctioning approaches on incident ventilator-associated pulmonary infection in patients with chronic obstructive pulmonary disease(COPD)undergoing mechanical ventilation.Methods Eighty COPD patients undergoing mechanical ventilation were enrolled and randomly divided into observation group and control group,with 40 cases in each group.The observation group underwent closed endotracheal sputum suctioning,while the control group underwent open endotracheal sputum suctioning.The two groups were compared in terms of the incidence rate of ventilator-associated pneumonia(VAP),duration of mechanical ventilation,hospital stay,the Clinical Pulmonary Infection Score(CPIS),as well as the detection rates of bacteria 24,48 and 72 hours after intubation and at extubation.Results The observation group exhibited lower incidence rate of VAP,shorter duration of mechanical ventilation,and reduced hospital stay as compared with the control group,CPIS scores of the observation group were lower than those of the control group on the 3rd,5th and 7th day after intubation(P<0.05),together with the detection rates of bacteria 48 and 72 hours after intubation and at extubation lower than the controls(P<0.05).Conclusion The use of closed sputum suctioning can effectively reduce the incidence rate of VAP and decrease the duration of mechanical ventilation and hospital stay in COPD patients during mechanical ventilation.

关 键 词：密闭式吸痰 开放式吸痰 慢性阻塞性肺疾病 机械通气 呼吸机相关性肺炎 

分 类 号：R563[医药卫生—呼吸系统]