持续性湿化在喉癌患者气管切开术后护理的意义

[目的]探讨持续性湿化气管套管在气管切开术后护理中的意义。[方法]在32例喉癌气管切开患者中采用0.45%氯化钠湿化液加入一次性氧气雾化吸入器持续雾化,间断滴入1.25%碳酸氢钠溶液和0.45%氯化钠溶液,两者交替使用。[结果]吸痰次数较传统方法吸痰次数减少,间隔时间延长,套管壁无干痂,光滑湿润,无套管堵管发生。[结论]喉癌气管切开患者,使用一次性雾化吸入器持续性湿化,有利于保证气道通畅,减少了吸痰次数和不良反应。     

保济丸中葛根素的含量测定及灭菌方法评价

目的:建立保济丸中葛根素含量的测定方法,评价几种灭菌方法的优劣。方法:以甲醇-水(30∶70)为流动相,流速1.0 mL.min-1,检测波长250 nm,柱温30℃,用RP-HPLC测定经各种灭菌方法处理的保济丸中葛根素的含量与未经灭菌处理的保济丸中葛根素的含量。结果:葛根素在4.212～84.24 mg.L-1呈良好的线性关系(r=0.999 9),平均回收率98.18%,RSD 0.44%。湿热蒸汽灭菌方法在4种灭菌方法中属最优法。结论:定量测定方法简便、快速、灵敏、结果准确、重复性好,可作为保济丸的质量控制标准。     

Delivery of molecular versus particulate water in spontaneously breathing tracheotomized patients

BACKGROUND: Adequate humidification of inspired gas with active or passive humidifiers is a standard of care for tracheotomized patients. In this study, a comparison is made between the tracheal climate after tracheobronchial humidification either with molecular water (via a vaporizing humidifier) or particulate water (via spray) in spontaneously breathing tracheotomized patients. METHODS: We performed a randomized, 2-way crossover study on 10 tracheotomized patients. Tracheal humidity and temperature were measured prior to and after use of a vaporizing humidifier and aerosol spray, respectively. RESULTS: After use of both the vaporizing humidifier and the aerosol spray, the end-inspiratory total water content and water gradient in the upper trachea increased significantly, compared with baseline values before application. After end of use of the vaporizing humidifier, the total water content and the water gradient decreased significantly faster than after application of the aerosol spray. CONCLUSIONS: Delivery of both molecular and particulate water significantly increases the tracheal climate and conditioning in the tracheal airways. Because the tracheal humidity remained on a higher level after aerosol spray, we speculate that particulate water may be efficient on tracheal humidification for longer. However, the positive effect on tracheal humidity after prolonged application of the aerosol spray remains to be proven.     

Humidification of oxygen with unheated humidifiers in tropical climates

In developing countries, oxygen therapy in hospitals is frequently humidified with unheated bubble-through humidifiers. We assessed the efficacy of humidification under such circumstances. The water temperature in the humidifier and the ambient air temperature were measured and compared to the oxygen flow rate. It was calculated that oxygen was cooled in the humidifier by 6.12°C (95% Cl: 5.88; 6.35) per liter of flow for flow rates up to 2 l/min. Using the average temperatures on the hospital ward in January and August, and the WHO-recommended flow rates of 0.5 l/min and 1 l/min, the relative humidity of the oxygen delivered to a child was estimated to be between 34% and 56%. We conclude that unheated bubble-through humidifiers achieve low humidity in oxygen in tropical climates. Some of the complications associated with the use of nasopharyngeal catheters for the delivery of oxygen might be explained by this, as oxygen of low humidity and temperature is delivered directly into the posterior nasopharynx. Pediatr Pulmonol. 1996; 22:125–128. © 1996 Wiley-Liss, Inc.     

低温等离子改良悬雍垂腭咽成形术后精确气道湿化疗效观察

目的通过前瞻性的病例对照研究探讨精确气道湿化对低温等离子悬雍垂腭咽成形（H UPPP）术后患者伤口出血量、咽痛、黏膜淤血水肿和痰液黏稠度的影响。方法将49例H UPPP患者按随机数字法分为：精确气道湿化组（18例）、氧气雾化吸入组（16例）和对照组（15例）。精确气道湿化组采用AIRVOTM系列呼吸湿化治疗仪雾化吸入，氧气雾化吸入组采用布地奈德混悬液氧气雾化吸入，对照组采用生理盐水行氧气雾化吸入。术后连续3 d对患者伤口出血量、咽痛、黏膜淤血水肿情况和痰液黏稠度进行评估。结果精确气道湿化组和氧气雾化吸入组患者术后第2天、第3天咽痛均较对照组明显改善（P<0.01），且精确气道湿化组术后黏膜淤血水肿及痰液黏稠度改善均明显好于氧气雾化吸入组（P<0.05）和对照组（P<0.05）。结论精确气道湿化可显著减轻H UPPP术后伤口疼痛、改善黏膜淤血水肿和痰液黏稠度，促进患者早期恢复。