高流量湿化氧疗对颅脑损伤气管切开非机械通气患者院内获得性肺炎预防效果分析.docVIP

高流量湿化氧疗对颅脑损伤气管切开非机械通气患者院内获得性肺炎预防效果分析 　　[摘要] 目的 探讨高流量鼻导管湿化氧疗对颅脑损伤气管切开非机械通气患者院内获得性肺炎预防的效果。 方法 将92例颅脑损伤气管切开非机械通气患者根据气道氧疗湿化的不同分为实验组和对照组，每组各46例，实验组给予HHFNC治疗；对照组给予经湿化瓶鼻导管给氧治疗。比较两组患者院内获得性肺炎的发生率及痰液情况。 结果 实验组采用HHFNC对患者进行湿化及氧疗，可以有效降低气管切开患者院内获得性肺炎的发生率，差异有统计学意义（P0.05），气管切开2周时，对照组院内获得性肺炎的发生率达到了45.6%，而实验组仅21.7%。两者差异显著（P=0.028）同时可以使患者的气道湿化达到满意，痰液粘稠度理想，差异有统计学意义（P0.05）。 结论 对于气管切开非机械通气的患者使用HHFNC预防院内获得性肺炎疗效确切，值得推广。 　　[关键词] 高流量氧疗湿化；气管切开；院内获得性肺炎；湿化 　　[中图分类号] R651.1 [文献标识码] A [文章编号] 2095-0616（2017）20-218-03 　　Effect analysis of high flow humidification oxygen therapy on prevention of nosocomial pneumonia in patients with traumatic brain injury undergoing tracheotomy and non mechanical ventilation 　　HE Liqiong GE Gaizhen 　　Department of Respiration and Critical Care Medicine，the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of ScienceTechnology，Baotou 014010，China 　　[Abstract] Objective To investigate the effect of Humidified high flow nasal cannula （HHFNC） on prevention of hospital acquired pneumonia in patients with traumatic brain injury undergoing tracheotomy and non mechanical ventilation. Methods 92 patients with craniocerebral injury treated with tracheotomy and non mechanical ventilation were divided into experimental group and control group according to the difference of airway oxygen therapy humidification，46 cases in each group.The experimental group was treated with HHFNC，while the control group was treated with humidified nasal tube oxygen therapy.The incidence of hospital acquired pneumonia and sputum were compared between the two groups. Results The use of HHFNC humidification and oxygen therapy in the experimental group can effectively reduce the incidence of hospital acquired pneumonia in patients with tracheotomy，and the difference was statistically significant（P0.05）.At 2 weeks after tracheotomy，the incidence of hospital acquired pneumonia in the control group was 45.6%，which in the experimental group was only 21.7%.There was s