定时清洁气管导管内壁对降低VAP发生的价值研究
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摘要
目的探讨定时清洁气管导管内壁对降低呼吸机相关性肺炎(VAP)发生的价值研究。方法 86例进行气管插管机械通气治疗患者,根据干预方式不同分为研究组和对照组,每组43例。对照组采用常规方法预防VAP,研究组在常规方法基础上加定时清洁气管导管内壁预防VAP,并将两组机械通气不同阶段VAP发生率及机械通气时间等相关指标进行对比,对比两组患者误吸率及病死率。结果研究组机械通气7~10 d、11~14 d VAP发生率(4.65%、9.30%)均明显低于对照组(18.60%、25.58%)(P<0.05)。研究组机械通气时间、重症监护病房(ICU)留置时间、住院时间均明显短于对照组(P<0.05)。研究组患者误吸率为2.33%,无死亡病例;对照组患者误吸率、病死率分别为13.95%、9.30%,两组比较差异具有统计学意义(P<0.05)。结论对ICU气管插管机械通气患者采用定时清洁气管导管内壁可有效降低VAP发生率,在预防VAP方面效果显著,对缩短患者机械通气时间、防止误吸、降低患者病死率等均具有积极意义。
Objective To discuss the value of regular cleaning of endotracheal tube internal wall for reducing the occurrence of ventilator-associated pneumonia(VAP).Methods A total of 86 patients with tracheal intubation mechanical ventilation were divided by different invention methods into research group and control group,with 43 cases in each group.The control group received conventional method for prevention of VAP,and the research group received regular cleaning of endotracheal tube internal wall for prevention of VAP on the basis of conventional method.Comparison were made on incidence of VAP at different stages of mechanical ventilation,duration of mechanical ventilation,mistaken aspiration rate and mortality between the two groups.Results The research group had obviously lower incidence of VAP at 7~10 d and 11~14 d of mechanical ventilation(4.65% and 9.30%) than the control group(18.60% and 25.58%)(P<0.05).The research group had obviously shorter duration of mechanical ventilation,retention time of intensive care unit(ICU) and hospitalization time than the control group(P<0.05).The research group had mistaken aspiration rate as 2.33%,and no death case,while the control group had mistaken aspiration rate and mortality respectively as 13.95% and 9.30%.their difference was statistically significant(P<0.05).Conclusion Regular cleaning of endotracheal tube internal wall for patients with tracheal intubation mechanical ventilation in ICU can effectively reduce the occurrence of VAP,and it has a significant effect in preventing VAP.It is of great significance to shorten the duration of mechanical ventilation,prevent mistaken aspiration,and reduce the mortality of patients.
Objective To discuss the value of regular cleaning of endotracheal tube internal wall for reducing the occurrence of ventilator-associated pneumonia(VAP).Methods A total of 86 patients with tracheal intubation mechanical ventilation were divided by different invention methods into research group and control group,with 43 cases in each group.The control group received conventional method for prevention of VAP,and the research group received regular cleaning of endotracheal tube internal wall for prevention of VAP on the basis of conventional method.Comparison were made on incidence of VAP at different stages of mechanical ventilation,duration of mechanical ventilation,mistaken aspiration rate and mortality between the two groups.Results The research group had obviously lower incidence of VAP at 7~10 d and 11~14 d of mechanical ventilation(4.65% and 9.30%) than the control group(18.60% and 25.58%)(P<0.05).The research group had obviously shorter duration of mechanical ventilation,retention time of intensive care unit(ICU) and hospitalization time than the control group(P<0.05).The research group had mistaken aspiration rate as 2.33%,and no death case,while the control group had mistaken aspiration rate and mortality respectively as 13.95% and 9.30%.their difference was statistically significant(P<0.05).Conclusion Regular cleaning of endotracheal tube internal wall for patients with tracheal intubation mechanical ventilation in ICU can effectively reduce the occurrence of VAP,and it has a significant effect in preventing VAP.It is of great significance to shorten the duration of mechanical ventilation,prevent mistaken aspiration,and reduce the mortality of patients.
引文
[1]黄涛,王娟,敖薪.气管导管改造和护理改良对预防呼吸机相关性肺炎的效果分析.中国实用护理杂志,2015,31(10):730-734.
[2]程安琪,李雅楠,夏欣华,等.两种气管导管预防机械通气患者呼吸机相关性肺炎效果比较.护理学杂志,2017,32(13):24-27.
[3]马丽,仲光.气管导管细菌生物膜与呼吸机相关性肺炎的临床研究进展.中华老年多器官疾病杂志,2016,15(11):877-880.
[4]姜文彬,任常洁,周丹,等.锥形套囊气管导管预防呼吸机相关性肺炎的应用研究.中华医院感染学杂志,2016,26(22):5125-5127.
[5]郭晓伟,刘志敏,龚秀琴,等.不同间断控制气管导管套囊压力时间对呼吸机相关性肺炎发生的影响.现代临床护理,2017,16(6):22-25.
[6]苏莉洁.浅层吸痰对新生儿呼吸机相关性肺炎的影响.齐鲁护理杂志,2016,22(17):97-98.
[7]刘德军,魏晓晶,凌艳姣.急诊气管插管后呼吸机相关性肺炎的危险因素.中华医院感染学杂志,2014,24(2):377-379.
[8]赵浩天,王光英,龙玲,等.呼吸机相关性肺炎预防的研究进展.中国急救医学,2017,37(8):762-766.
[9]倪淑红,颜喜梅.呼吸机相关性肺炎的预防研究进展.中华医院感染学杂志,2010,20(15):2356-2357.
[10]卜春红,马晓彬,朱孝芹.呼吸机相关性肺炎预防的研究进展.河北医学,2010,16(7):895-896.
[2]程安琪,李雅楠,夏欣华,等.两种气管导管预防机械通气患者呼吸机相关性肺炎效果比较.护理学杂志,2017,32(13):24-27.
[3]马丽,仲光.气管导管细菌生物膜与呼吸机相关性肺炎的临床研究进展.中华老年多器官疾病杂志,2016,15(11):877-880.
[4]姜文彬,任常洁,周丹,等.锥形套囊气管导管预防呼吸机相关性肺炎的应用研究.中华医院感染学杂志,2016,26(22):5125-5127.
[5]郭晓伟,刘志敏,龚秀琴,等.不同间断控制气管导管套囊压力时间对呼吸机相关性肺炎发生的影响.现代临床护理,2017,16(6):22-25.
[6]苏莉洁.浅层吸痰对新生儿呼吸机相关性肺炎的影响.齐鲁护理杂志,2016,22(17):97-98.
[7]刘德军,魏晓晶,凌艳姣.急诊气管插管后呼吸机相关性肺炎的危险因素.中华医院感染学杂志,2014,24(2):377-379.
[8]赵浩天,王光英,龙玲,等.呼吸机相关性肺炎预防的研究进展.中国急救医学,2017,37(8):762-766.
[9]倪淑红,颜喜梅.呼吸机相关性肺炎的预防研究进展.中华医院感染学杂志,2010,20(15):2356-2357.
[10]卜春红,马晓彬,朱孝芹.呼吸机相关性肺炎预防的研究进展.河北医学,2010,16(7):895-896.