气管切开与细菌生物膜的关系及护理对策.docVIP

气管切开与细菌生物膜的关系及护理对策 (厦门大学附属中山医院耳鼻喉科福建厦门361004) 【摘要】目的：探讨气管切开对细菌形成生物膜能力的影响，指导气管切开 术后护理对策改进。方法：采集65例行气管切开的重症病房病人术后3天和术 后10天气道分泌物拭子进行细菌培养。采用改良Moskowitz生物膜分析法，标 准化稀释细菌悬浮液、生物膜培养、结晶紫染色、干燥和乙醇溶解吸附结晶紫后， 用酶标仪读取595nm光密度(OD595),测量生物膜的形成量。以自身对照，比 较两次气道分泌物中细菌形成生物膜的能力。结果：气管切开后气道细菌形成生 物膜的能力增强，两组差异有统计学意义(U=1601, Plt;0.05)o结论：气管切 开可诱导细菌获得更强的生物膜形成能力，并且随着气管切开的时间延长而增强。 气管切开术后的护理对策改进非常重要。 【关键词】气管切开：生物膜：细菌：护理对策 【中图分类号】R473.76 【文献标识码】A 【文章编号】1007-8231 (2016) 11-0008-02 The relationship between tracheotomy and bacterial biofilm and nursing countermeasures Yang Shuyan,Yang Haibin (Communications author), Xu Guohua. Department of ENT, the affiliated Zhongshan hospital, Xiamen University, 361004,China 【Abstract】 Objective To explore tracheotomy on the formation of bacterial biofilm ability influence and guidance after tracheotomy nursing countermeasures of improvement. Methods 3 days and 10 days after operation, 65 days and days after operation, the bacterial culture of airway secretions was collected. Using modified Moskowitz biological membrane method, standard of diluted suspension of bacteria and biofilm cultivation, crystal violet staining, drying and dissolved in ethanol adsorption of crystal violet, enzyme standard instrument read 595 nm optical density (OD595), measuring biofilm formation. The ability of bacterial biofilm formation in the two airway secretions was compared with that of the control group. Results The ability of bacteria to form biofilm after tracheotomy was enhanced, and the difference between the two groups was statistically significant (U = 1601, P lt; 0.05). Conclusion Tracheotomy can induce the bacteria to get stronger biofilm formation ability, and increase with the time of tracheotomy. Improved nursing after tracheotomy is very important. 【Keywords】 Tracheotomy; Biofilm; Bacteria; Nursing strategy 气管切开后，呼吸道免疫力降低，易感性增加［1】。术后常出现气道分泌物 量及性质的改变，分泌物多且黏稠，并可能引发肺部感染，也是院内感染的常见 原因。虽然对于气管切开后细菌感染已冇广泛的研究，但冇关气管切开对细菌形 成生物膜的能力的影响还不清楚，因而护理的对策针对性不强。 资料与方法 1.1临床资料 我院2014年1月至2016年1月重症