可吸痰式气管切开插管预防呼吸机相关性肺炎的效果观察

目的观察可吸痰式气管切开插管对预防呼吸机相关性肺炎（ventilato rassociated pneumonia，VAP）的临床价值。方法便利选取2010年1月至2012年1月在海军安庆医院ICU治疗的66例经气管切开行机械通气（mechanical ventila—tion，MV）患者为研究对象，按入院先后将其分为对照组（n=34）和观察组（n=32）。对照组患者使用一次性气管切开插管，观察组患者使用可吸痰式气管切开插管，观察两组患者VAP的发生率以及呼吸机停用的时间。结果 4d内，观察组患者VAP的发生率为12．5％，低于对照组的41．1％，差异有统计学意义（P〈0．05）；观察组MV使用时间明显短于对照组，差异有统计学意义（P〈0．05）。4d后，两组患者VAP的发生率分别为28．1％和35．3％，差异无统计学意义（P〉0．05）。结论应用可吸痰式气管切开插管可略低早发性VAP的发生率及MV的使用时间．但并不能隆低VAP的发生率。

Effects of Suck Phlegm Type Tracheostomy Cannula on Preventing Ventilator-Associated Pneumonia

Objective To observe the effects of Suck phlegm type tracheostomy cannula on preventing ventilator-associated pneumonia （VAP）. Methods Sixty-six patients with tracheotomy and mechanical ventilation （MV） in the ICU were divided into two groups. The control group of 34 cases of the use of dis- posable tracheal intuhation. The observation group of 32 cases used suction type incision of trachea intuba- tion. The incidence and time of the ventilator discontinuation were observed and compared. Results Within 4 days of MV,incidence of VAP for observational group （12.5%）was significantly lower than that in the control group （41.1%） （P~0.05）. Time for MV in the observational group was obviously shorter than that in the control group（P〈0.05）. After 4 days＇ MV,incidence of VAP for observational group and con- trol group were 28.1% and 35.3% ,respectively. The difference in VAP for the two groups were not sig- nificant（P〉0.05）. Conclusion Application of suction type tracheotomy tube can reduce the incidence rate and the MV time of early-onset VAP,but it does not reduce the incidence of late-onset VAP.