中低流量吸氧患者三种氧气湿化装置细菌污染情况调查分析

目的探讨中低流量吸氧（≤4L／min）患者使用三种氧气温化装置细菌污染情况，为临床氧疗选择合适的湿化装置提供参考。方法将120倒在ICU住院并且需要持续中低流量吸氧7d以上的患者随机分为A、B、C三组各40例，A组给氧时使用传统的湿化装置，B组使用未湿化装置，C组使用ε-聚赖氨酸湿化液湿化装置。比较三组氧气湿化装置使用前后不同时点细菌污染情况，了解污染细菌种类。结果使用前所有样本细菌培养均无菌生长。三组使用后氧气湿化装置细菌阳性率总体比较，差异有统计学意义（P〈0．01），C组显著低于B组，B组显著低于A组（均P〈0．0125）；使用后24～168h，C组细菌阳性率显著低于A组（均P〈0．0125）；使用后第72～168h，C组细菌阳性率显著低于B组（均P〈0．0125）；A组高于B组，但两组差异无统计学意义（均P〉0．0125）；检出的主要菌群为肠杆菌、葡萄球菌、真菌。结论ε-赖氨酸湿化液湿化瓶染菌最少，其次是非湿化瓶，中低流量吸氧时24h内可选用非湿化瓶，超过24h适合选用ε-赖氨酸湿化液湿化瓶。

Bacterial contamination of three types of oxygen humidifier reservoirs used in low to medium flow oxygen therapy

Objective To explore bacterial contamination of three types of oxygen humidifier reservoirs used in low to medium flow （≤4 L/min） oxygen therapy, and to provide information for selecting an appropriate humidifier for oxygen therapy. Methods A to- tal of 120 patients hospitalized in ICU and requiring continuous low to medium flow oxygen therapy more than 7 consecutive days were randomized into group A, B, and C, with 40 cases in each group. Group A used reusable oxygen humidifier bottles filled with sterile water, while group B received dry oxygen without the use of humidifier. Group C received a disposable oxygen inhalation de- vice with ε-lysine solution for humidification of oxygen. Bacterial contaminations were compared among the 3 groups before and af ter the use of oxygen humidifier reservoirs, and bacteria types were tested. Results No bacterial growth was detected in all reser voirs before the operation of the oxygen supply. The rate of positive bacterial cultures from the 8 types of reservoirs had sig-nificant difference （P〈0.01）, with significant differences between each two groups （C〈B〈A,P〈0. 0125 for all）. The positive rates in group C were significantly lower than those in group A on the 24th-168th h, and were significantly lower compared to group B on the 72th-168th h （P〈0. 0125 for all）. The microorganisms identified from the reservoirs included Enterobacter, Staphylococcus, and fungi. Conclusion Oxygen humidifier reservoirs filled with ε-lysine solutions could reduce bacterial growth at maximum extent, followed by the bottles without humidification solution. If low to medium flow oxygen therapy was required less than 24 h, we could select bottles without humidification solution. The use of ε-lysine solution for humidification is recommended for patients re quiring more than 24 h therapy.