| 李杰,徐英,江金桐.持续人工气道气囊压力控制联合声门下吸引预防呼吸机相关性肺炎53例[J].安徽医药,2019,23(9):1838-1841. |
| 持续人工气道气囊压力控制联合声门下吸引预防呼吸机相关性肺炎53例 |
| Continuous control of tracheal cuff pressure and subglottic secretion drainage for preventing ventilator-associated pneumonia |
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| DOI：10.3969/j.issn.1009-6469.2019.09.036 |
| 中文关键词: 肺炎，呼吸机相关性 气囊压力 声门下吸引 误吸 |
| 英文关键词: Pneumonia,ventilator-associated Cuff pressure Subglottic attraction Pepsin |
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| 中文摘要: |
| 目的 探讨持续人工气道气囊压力控制联合声门下吸引预防呼吸机相关性肺炎(VAP)临床效果。方法 选择2015年3月至2017年9月宜宾市第一人民医院收治的106例气管插管病人为研究对象，按入院时间的先后次序将病人分为观察组和对照组，各53例。两组均予以持续声门下吸引。对照组予以德国VBM气囊压力测量表，每4小时测量气囊压力并予以调节；观察组予以持续气囊压力控制装置进行气囊压力监控。比较两组气囊压力达标率、声门下引流量、痰液胃蛋白酶、VAP发生率、机械通气时间及28 d病死率。结果 观察组气囊压力达标率99.37%高于对照组60.38%(P＜0.05)；观察组在第1、2、3天声门下引流量(41.15±7.23)、(46.58±5.43)、(47.00±7.71)mL/24 h多于对照组(24.71±5.25)、(30.32±6.18)、(31.81±4.68)mL/24 h(P＜0.05)；插管后48 h、72 h观察组痰胃蛋白酶水平低于对照组(P＜0.05)；观察组VAP发生率、机械通气时间小于对照组(P＜0.05)；两组28 d病死率比较，差异无统计学意义(P＞0.05)。结论 对气管插管机械通气病人予以持续气囊压力监测联合声门下吸引可降低病人误吸和VAP发生率，缩短机械通气时间，但对病死率无明显影响。 |
| 英文摘要: |
| Objective To explore the effect of continuous control of tracheal cuff pressure and subglottic secretion drainage for preventing ventilator-associated pneumonia (VAP).Methods One hundred and six cases with intubation admitted to The First People--s Hospital of Yibin City from March 2015 to September 2017 were selected as the research subjects.According to the order of admission time，the patients were assigned into the observation group and the control group，with 53 cases in each.The two groups were attracted by the continuous glottis.The control group used German VBM airbags pressure gauge to measure and regulate cuff pressure six times a day.The observation group used Arto continuous air pressure control device to continuously control the cuff pressure.The air bag pressure standard rate，subglottic flow rate，sputum pepsin，incidence of VAP，mechanical ventilation time and 28d mortality of the two groups were compared.Results The rate of air bag pressure in the observation group was higher than that of the control group 99.37% vs. 60.38%(P＜0.05).The subglottic flow rate of the observation group (41.15±7.23)，(46.58±5.43)，(47.00±7.71)mL/24 h was more than that of the control group at the 1 d，2 d and 3 d (24.71±5.25)，(30.32±6.18)，(31.81±4.68)mL/24 h(P＜0.05).After 48 h and 72 h intubation，the level of phlegm pepsin of the observation group was lower than that of the control group (P＜0.05).The incidence of VAP rate and the time of mechanical ventilation in the observation group were less than that of the control group (P＜0.05).There was no significant difference in the 28 d mortality of the two groups (P＞0.05).Conclusion Continuous control of tracheal cuff pressure and subglottic secretion drainage for the patients with requiring endotracheal intubation mechanical ventilation can reduce the incidence of aspiration and VAP amd shorten the duration of mechanical ventilation，with no significant effect on mortality. |
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