不同气道湿化方法用于气管插管患者效果比较.docVIP

不同气道湿化方法用于气管插管患者效果比较 　　摘要：目的探讨气管插管患者应用不同气道湿化方法的效果。方法选择气管插管且不需要机械通气治疗的患者120例，按入院先后顺序分为三组，A组（精密输液器组）、B组（低流量持续雾化组）、C组（一次性MR850湿化系统双加热式呼吸机湿化管道组）。分别评估各组患者气道痰液粘稠度的变化；肺部感染发生率；记录各组3 d平均日护理工时及湿化所需日医疗费用。结果在分泌物性状控制、护理工时方面，C组较另外两组有显著优势，B组优于A组；C组花费最多；各组的肺部感染率无统计学差异。结论一次性MR850湿化系统双加热式呼吸机湿化管道湿化更适用于气管插管患者，是理想的气道湿化方法。 　　关键词：气管插管；气道湿化 　　The Efficacy of Ddifferent Airway Humidification Methods in Patients with Intratracheal Intubation 　　YANG Xue-lian，ZHAO Qing-hua，YU Hua 　　(Department ofNeurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016,China) 　　Abstract：ObjectiveTo evaluate the efficacy of three airway humidification methods in patients with Intratracheal Intubation. Methods Totally 120 cerebral disease patients with Intratracheal intubation and do not require mechanical ventilation were randomly divided into three groups according to the order of admission .A (Precision I.V. Flow Control Device group), B (low-flow continuous atomization group), C (MR850 humidifying device group). The change of airway secretions, pulmonary infection incidence, nursing hours and medical expense within three days were recorded and compared between the three groups. Results Group C was superior in airway secretion and nursing hours compared to group B and group A. The expense was highest in group C. The pulmonary infection incidence during three groups was no significant difference. ConclusionMR850 humidifying device is more suitable for patients with intratracheal intubation. It is an ideal airway humidification method. 　　Key words：Intratracheal Intubation；Humidification气管插管对解决呼吸道梗阻，抢救生命有重要的作用，但气管插管后，鼻咽部对气体的温湿化重要作用就消失了，未经温湿化的气体吸入后导致下呼吸道失水、粘膜干燥、分泌物干燥及排痰不畅，进而导致肺部感染、肺不张；与气管切开比较，气管插管患者气道阻力高，痰液排除的通道更长，更容易出现痰液粘稠，肺部感染。如何采用合适的气道湿化方法，使得患者痰液易于排除，减少肺部感染是气道管理的重点工作。目前临床上气道湿化的方法较多包括间断推注湿化法、输液管持续滴入法、注射泵持续湿化法、人工鼻法、低流量持续雾化法、雾化加湿[1-3]等，哪种湿化方法更适合气管插管是值得探讨的问题。本文旨在探讨不同气道湿化方法应用于气管插管的效果比较。 　　1资料与方法 　　1.1一般资料 选择2010年1月~2013年2月入住我院神经外科的气管插管患者，纳入标准：①意识障碍，或其他原因致呼吸异常需要行气管插管的患者②无需机械通气治疗者