经口气管插管患者流涎症现况调查及影响因素研究  

Current status and influencing factors of salivation in patients with orotracheal cannula

作　　者：杜金磊 聂臣聪[1] 雷玲[1] 赵洪祥[1] 张琦玉 叶群 彭古涛 陈志美 张尚书 DU Jinlei;NIE Chencong;LEI Ling;ZHAO Hongxiang;ZHANG Qiyu;YE Qun;PENG Gutao;CHEN Zhimei;ZHANG Shangshu(Department of Intensive Care Medicine,Zigong Fourth People’s Hospital,Zigong,Sichuan 643000,P.R.China;School of Nursing,North Sichuan Medical College,Nanchong,Sichuan 637000,P.R.China;Department of Critical Care Medicine,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang 310000,P.R.China;Department of Neurosurgery,the Affiliated Fuling Hospital of Chongqing University,Chongqing 408000,P.R.China;Department of Critical Care Medicine,the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang,Guizhou 550000,P.R.China;Department of Critical Care Medicine,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,P.R.China)

机构地区：[1]自贡市第四人民医院重症医学科,四川自贡643000 [2]川北医学院护理学院,四川南充637000 [3]浙江大学第二附属医院重症医学科,杭州310000 [4]重庆大学附属涪陵医院神经外科,重庆408000 [5]贵州中医药大学第二附属医院重症医学科,贵阳550000 [6]徐州医科大学附属医院重症医学科,江苏徐州221000

出　　处：《华西医学》2024年第6期913-919,共7页West China Medical Journal

基　　金：自贡市卫生健康委员会科研课题(23yb077);自贡市科技局重点科技计划项目(2022ZCYGY30,2023-YGY-3-02);重庆市涪陵区科卫联合医学科研项目(2023KWLH020)。

摘　　要：目的了解目前国内经口气管插管患者流涎症的发生现况,并对其影响因素展开系统分析。方法2023年10月10日—20日,采用横断面调查法对47所三级综合性医疗机构内行气管插管治疗的患者流涎症发生现况展开线上调查。将纳入患者分为发生流涎症组和未发生流涎症组。结果共回收问卷565份,有效问卷561份,有效回收率99.29%。在561例患者中,男性284例(50.62%),女性277例(49.38%),年龄(59.80±10.96)岁;发生流涎症159例,静止唾液总流率为(7.21±3.15)mL,流涎症发生率为28.34%(159/561)。发生与未发生流涎症组间的年龄、文化程度、体质量指数、原发疾病、合并功能障碍系统数量、合并口腔疾病、吸烟、插管天数、插管深度、插管过程、镇静和/或镇痛天数、肠内营养治疗比较,差异均有统计学意义(P<0.05);其余指标,两组间比较差异均无统计学意义(P>0.05)。多因素logistic回归分析结果显示,体质量指数、神经系统疾病、合并功能障碍系统数量、合并口腔疾病、吸烟、插管天数以及插管过程是经口气管插管患者流涎症发生的独立危险因素(P<0.05)。结论经口气管插管患者流涎症发生率为28.34%,该症状主要与患者体质量指数、神经系统疾病、合并功能障碍系统数量、合并口腔疾病、吸烟、插管天数以及插管过程具有直接关联性。Objective To investigate the current situation of salivation in patients with orotracheal cannula,and to systematically analyze its influencing factors.Methods Patients who underwent tracheal intubation treatment in 47 tertiary comprehensive medical institutions were selected between October 10th and 20th,2023.A cross-sectional survey method was used to conduct an online survey of the patient’s salivation status.The patients were divided into the salivation group and no-salivation group.Results A total of 565 questionnaires were collected and 561 were valid,with an effective recovery rate of 99%.Among 561 patients,284 were males(50.62%)and 277 were females(49.38%),with an age of(59.80±10.96)years;159 cases of salivation occurred,with a total static saliva flow rate of(7.21±3.15)mL and the incidence of salivation was 28.34%(159/561).There were statistically significant differences in age,education level,body mass index,primary disease,number of concurrent functional impairments,concurrent oral diseases,smoking,intubation days,intubation depth,intubation process,sedation and/or analgesia days,and enteral nutrition treatment between the two groups(P<0.05).There was no statistically significant difference in other indicators between the two groups(P>0.05).The results of multivariate logistic regression analysis showed that body mass index,neurological diseases,number of concurrent functional impairments,concurrent oral diseases,smoking,intubation days and intubation process were independent risk factors for salivation in patients with oral catheterization.Conclusion The incidence of salivation in patients with orotracheal cannula is 28.34%,which is directly related to body mass index,neurological diseases,number of concurrent functional impairments,concurrent oral diseases,smoking,intubation days and intubation process.

关 键 词：气管插管 流涎症 发生现况 影响因素 

分 类 号：R459.7[医药卫生—急诊医学]