一种降低VAP发生率的全封闭式吸痰管冲洗装置的设计与运用  

Design and application of flushing device of a totally enclosed sputum suction tube for reducing the incidence of ventilator-associated pneumonia

作　　者：彭俏俏 杨湘英 曾小康 Peng Qiaoqiao;Yang Xiangying;Zeng Xiaokang(Department of Critical Care Medicine,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medical,Hangzhou 310006,Zhejiang,China)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院重症监护室,浙江杭州310006

出　　处：《中华危重病急救医学》2022年第8期871-872,共2页Chinese Critical Care Medicine

基　　金：浙江省杭州市社会发展自主申报项目(20180533B35);国家实用新型专利(CN 201921198740.5)。

摘　　要：呼吸机相关性肺炎(VAP)是重症监护病房(ICU)行机械通气患者最常见的感染性疾病之一。尽管使用封闭式吸痰管行吸痰操作是ICU气管插管患者最常见的护理措施,也是减少VAP发生的重要措施,但临床现有技术仍需使用外接冲管液进行湿化和冲洗。在使用过程中,该冲管操作存在无法控制冲洗液量,导致大量冲洗液进入患者气道,造成患者窒息的风险。附着在吸痰管壁的痰液无法完全冲净,痰液长时间滞留导致定植菌繁殖,加重患者感染情况。多次冲管既增加了耗材,又增加了医护人员的工作量。为此笔者设计了一种全封闭式吸痰管冲洗装置,获得了国家实用新型专利(专利号:CN 201921198740.5),此装置为一体化设计,吸痰、湿化、冲管用物全封闭,均无空气暴露,可严格进行无菌操作;注射器脉冲式冲洗可洗净附着于内壁的痰液,降低VAP发生率;使用过程中可有效控制冲洗液量,保证患者安全,减少浪费;优化操作步骤,减轻医护人员工作量,值得临床实践推广应用。Ventilator-associated pneumonia(VAP)is one of the most common infectious diseases in patients undergoing mechanical ventilation in intensive care unit(ICU).Although the use of closed sputum suction tube for sputum suction is the most common nursing measure for patients with tracheal intubation in ICU,and it is also an important measure to reduce the occurrence of VAP,the existing clinical technology still needs to use external flushing solution for humidification and flushing.In the process of use,the flushing operation has the risk that the amount of flushing fluid cannot be controlled,resulting in a large amount of flushing fluid entering the patient's airway,causing the patient to suffocate.The sputum attached to the wall of the sputum suction tube cannot be completely flushed,and the prolonged retention of the sputum leads to the proliferation of colonized bacteria,aggravating the infection of patients.Repeated pipe flushing not only increases consumables,but also increases the workload of medical staff.For this reason,the author has designed a fully enclosed sputum suction tube flushing device,which has obtained the National Utility Model Patent of China(patent number:CN 201921198740.5).This device is an integrated design,and the materials used for sputum suction,humidification and flushing are fully enclosed,without air exposure,and can be operated strictly without bacteria.Pulse flushing with syringe can clean the sputum attached to the inner wall and reduce the incidence of VAP.The volume of flushing fluid can be effectively controlled during use to ensure patient safety and reduce waste.It is worth popularizing and applying in clinical practice to optimize the operation steps and reduce the workload of medical staff.

关 键 词：封闭式吸痰管 呼吸机相关性肺炎 应用 

分 类 号：R472[医药卫生—护理学]