不同气道湿化液在颅脑损伤气管切开患者中的应用效果对比研究  

Comparative study on the application effect of different airway humidifying fluids in patients with craniocerebral injury undergoing tracheotomy

作　　者：王烁 楼彦明 WANG Shuo;LOU Yan-ming(Department of Critical Care Medicine,Yiwu Central Hospital,Yiwu 322000,China)

机构地区：[1]义乌市中心医院重症医学科,浙江义乌322000

出　　处：《医师在线》2024年第6期45-48,共4页Journal of Doctors Online

基　　金：义乌市科研计划项目(21-3-54)。

摘　　要：目的对比不同气道湿化液在颅脑损伤气管切开患者中的应用效果。方法选取2022年1月~2023年12月义乌市中心医院重症医学科收治的80例颅脑损伤气管切开患者为研究对象,采用随机数字表法分为对照组和研究组,每组40例。两组患者均接受吸痰、排痰、密切监测生命体征以及营养支持等常规治疗,对照组给予灭菌生理盐水气道湿化,研究组给予4.5 g/L低渗盐水气道湿化。对比两组气道湿化效果(湿化理想、湿化不足、湿化过度及痰痂形成率)、痰液pH值变化情况和湿化后痰液黏稠度(Ⅰ度、Ⅱ度、Ⅲ度占比),统计两组不良事件(刺激性咳嗽、呼吸道黏膜出血、呼吸机相关性肺炎等)发生情况。结果研究组气道湿化效果明显优于对照组(Z=3.125,P=0.002<0.05),痰痂形成率明显低于对照组(χ^(2)=4.507,P=0.034<0.05)。两组痰液pH值组间对比、时间对比、交互效应对比,差异均有统计学意义(P<0.05)。两组湿化第3天、湿化第7天痰液pH值均较湿化第1天升高,湿化第7天痰液pH值均较湿化第3天升高,差异具有统计学意义(P<0.05);研究组湿化第1天、湿化第3天和湿化第7天痰液pH值均明显高于对照组(P<0.05)。研究组湿化后痰液黏稠度低于对照组(Z=3.974,P=0.000<0.05),不良事件总发生率明显低于对照组(χ^(2)=5.000,P=0.025<0.05)。结论采用4.5 g/L低渗盐水气道湿化能提高颅脑损伤气管切开患者气道湿化效果,提高痰液pH值,降低痰液黏稠度,减少不良事件。Objective To compare the application effect of different airway humidifying fluids in patients with craniocerebral injury undergoing tracheotomy.Methods A total of 80 patients with craniocerebral injury undergoing tracheotomy admitted to the Department of Critical Care Medicine of Yiwu Central Hospital between January 2022 and December 2023 were selected as the research objects.They were divided into control group and study group by random number table method,with 40 cases in each group.Patients in both groups received routine treatment such as suctioning,expectoration,close monitoring of vital signs,and nutritional support.The control group was given airway humidification with sterilized saline,and the study group was given 4.5 g/L hypotonic saline airway humidification.Compared the airway humidification effect(ideal humidification,insufficient humidification,excessive humidification and sputum crust formation rate),the change in sputum pH and the viscosity of sputum after humidification(percentage ofⅠ,ⅡandⅢdegree)between the two groups.The incidence of adverse events(irritating cough,respiratory mucous hemorrhage,ventilator-associated pneumonia,etc.)in the two groups was statistically analyzed.Results The airway humidification effect of the study group was significantly better than that of the control group(Z=3.125,P=0.002<0.05),and the sputum scab formation rate was significantly lower than that of the control group(χ2=4.507,P=0.034<0.05).Comparison of sputum pH between the two groups,time and interaction effects showed statistically significant differences(P<0.05).The sputum pH of the 3rd day and 7th day of humidification in both groups were higher than those of the 1st day of humidification,and the sputum pH of the 7th day of humidification was higher than that of the 3rd day of humidification(P<0.05).The sputum pH in the study group was significantly higher than that in the control group of the 1st day,3rd day and 7th day of humidification(P<0.05).The sputum viscosity after humidification was lower i

关 键 词：颅脑损伤 气管切开 气道湿化 生理盐水 4.5 g/L低渗盐水 

分 类 号：R47[医药卫生—护理学]