呼吸机湿化器与人工鼻对创伤性颅脑损伤患者气管切开术后早期气道湿化的效果比较  

Comparison of Two Different Airway Humidification Methods in Patients with Traumatic Brain Injury After Tracheotomy

作　　者：叶庆玲[1] 肖勤[1] 陈梅[1] 濮德松 吴雨洁 许卫 YE Qing-ling;XIAO Qin;CHEN Mei;PU De-song;WU Yu-jie;XU Wei(ICU,Kunshan Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine,Kunshan,Jiangsu,215300,China)

机构地区：[1]南京中医药大学附属昆山市中医医院重症医学科,江苏昆山215300

出　　处：《中国血液流变学杂志》2021年第3期421-424,共4页Chinese Journal of Hemorheology

摘　　要：目的探讨呼吸机湿化器与人工鼻对颅脑外伤患者气管切开术后早期气道湿化的影响。方法选取南京中医药大学附属昆山市中医医院2019年1月—2020年12月收治的行气管切开的颅脑外伤患者56例,采取随机数字表法将患者分成呼吸机湿化器组与人工鼻组,每组28例。呼吸机湿化器组采用湿化器加温加湿。人工鼻组使用一次性人工鼻保温保湿,两组患者均接受常规护理。比较两组患者术后第1、3、5天动脉血氧分压(PaO2)与血氧饱和度(SPO2)值及肺部感染、痰痂形成、气道痉挛、气道出血等并发症发生率。结果术后第5天,呼吸机湿化器组的平均PaO2及SPO2较人工鼻组显著升高,差异有统计学意义(P<0.05)。两组患者肺部感染情况、痰痂形成、气道痉挛及气道出血发生率差异无统计学意义(P>0.05)。术后第1、3、5天,两组组内的Ⅱ、Ⅲ级痰液黏稠度人数逐渐增多,但两组间差异无统计学意义(P>0.05)。结论与人工鼻组相比,呼吸机湿化器组在术后早期呼吸道并发症方面无明显优势,但呼吸机湿化器能显著提高颅脑外伤患者的血氧含量,更适合长期卧床的气管切开患者。Objective To investigate the effect of ventilator heated humidifier and heat and moisture exchangers on early postoperative complications in patients with traumatic brain injury after tracheotomy.Methods 56 patients with brain injury who received airway humidification after tracheotomy in Kunshan Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine were recruited from January 2019 to December 2020.The patients were randomly divided into ventilator heated humidifier group and heat and moisture exchangers group,28 cases in each group.Ventilator heated humidifier was used for ventiliator heated humidifier group.The heat and moisture exchangers group used disposable heat and moisture exchangers to keep warm and moisturize,and both groups received routine nursing.PaO2 and SPO2 values,pulmonary infection,phlegm scab formation,airway spasm and airway bleeding were compared between the two groups on the 1st,3rd and 5th day after operation.Results There was no statistical significance in the incidence of pulmonary infection,sputum viscosity,phlegm scab formation,airway spasm and airway bleeding between the two groups(P>0.05).Compared with the heat and moisture exchangers group,the mean PaO2 and SPO2 in the ventilator heated humidifier group were significantly higher in the early postoperative period(P<0.05).Conclusion Although there is no significant difference in early postoperative respiratory complications between the ventilator heated humidifier group and the heat and moisture exchangers group,the ventilator heated humidifier group can significantly improve the blood oxygen content of patients with traumatic brain injury,and it is more suitable for bedridden patients.

关 键 词：呼吸机湿化器 人工鼻 颅脑外伤 气管切开术后 护理 

分 类 号：R651.15[医药卫生—外科学] R473[医药卫生—临床医学]