论文部分内容阅读
目的:探讨热湿交换细菌过滤器联合密闭式吸痰预防呼吸机相关性肺炎(VAP)的临床效果。方法:选取2010-2011年在本院ICU进行机械通气的158例患者,按照随机数字表法将其分成试验组80例和对照组78例。试验组采用热湿交换细菌过滤器联合密闭式吸痰,对照组采用加热湿化器联合开放吸痰。两组患者均给予化痰止咳、解痉平喘、纠正内环境紊乱、抗感染、每日2次口腔护理和床头抬高30°及营养支持等对症治疗。观察比较两组患者VAP发病率、28 d死亡率、机械通气时间和ICU住院时间的差异。结果:试验组的VAP发病率28.75%明显低于对照组的46.15%,且28 d死亡率18.75%明显低于对照组的34.62%,差异均有统计学意义(P<0.05)。试验组的机械通气时间明显少于对照组,差异有统计学意义(P<0.05),两组ICU住院时间比较差异无统计学意义(P>0.05)。结论:热湿交换细菌过滤器联合密闭式吸痰可以降低VAP发病率、28 d死亡率,缩短机械通气时间,对ICU住院时间无影响。
Objective: To investigate the clinical effect of combined heat and moisture exchange bacterial filter with closed suction to prevent ventilator associated pneumonia (VAP). METHODS: A total of 158 patients with mechanical ventilation in our hospital from 2010 to 2011 were divided into experimental group (n = 80) and control group (n = 78) according to random number table method. Experimental group using heat and humidity exchange bacteria filter combined suction closed, the control group with heating humidifier combined open suction sputum. Both groups were given symptomatic treatment of phlegm and relieving cough, antispasmodic and antiasthmatic, correcting internal environment disorders, anti-infective, oral care twice a day and bedside elevation of 30 ° and nutritional support. The incidence of VAP, the mortality at 28 days, the duration of mechanical ventilation and the length of ICU stay were observed and compared between the two groups. Results: The incidence of VAP in experimental group was significantly lower than that of control group (28.75%) and control group (46.15%), and the death rate at 28 days was 18.75%, which was significantly lower than that of control group (34.62%, P <0.05). The time of mechanical ventilation in the experimental group was significantly less than that in the control group (P <0.05). There was no significant difference in the length of hospital stay between the two groups (P> 0.05). Conclusion: The combination of heat and moisture exchange bacterial filter with closed suction can reduce the incidence of VAP, 28-day mortality and shorten the duration of mechanical ventilation, and have no effect on the length of stay in ICU.