YXX型一次性吸氧管产品中的氧气湿化液的临床研究

目的对临床使用YXX型一次性吸氧管产品中的氧气湿化液与使用蒸馏水作为氧气湿化液的调查研究。方法实验组50例患者予以YXX型一次性吸氧管作为常规吸氧护理材料,对照组50例患者予以蒸馏水作为湿化液吸氧,比较24h后YXX型一次性吸氧管中的氧气湿化液的细菌污染情况与蒸馏水作为湿化液的细菌污染情况及吸氧依从性的观察。结果实验组湿化液的细菌污染为0％,观察组湿化液的细菌污染为16％,实验组较观察组有显著差别,同时吸氧依从性有明显改善。结论YXX型一次性吸氧管作为常规吸氧护理材料临床观察可避免细菌污染,又可提高患者对吸氧的依从性,对防止院内感染具有重要意义。     

DSG一次性吸氧管在基层医院心内科的应用

[目的]探讨DSG一次性吸氧管在基层医院心内科应用的可行性,为临床选择合适的氧疗方式提供依据。[方法]将符合研究条件的100例在基层医院心内科住院且需要持续吸氧7d以上的病人,随机分观察组和对照组,观察组使用DSG一次性吸氧管吸氧,对照组使用常规湿化瓶吸氧,比较两组氧气湿化瓶细菌污染情况、病人满意度、直接护理时数。[结果]观察组氧气湿化瓶染菌量少于对照组(P0.01),吸氧噪声少于对照组(P0.05),除氧气异味项外其他咽喉舒适度均明显高于对照组(P0.05或P0.01),对照组每天更换湿化瓶、湿化液和处理污染湿化瓶耗时25.23 min±1.56min,观察组不需要更换湿化瓶和湿化液,节省了执行氧疗的时间。[结论]DSG一次性吸氧管在基层医院心内科使用,有利于降低湿化瓶细菌污染情况,减少工作量、吸氧噪声,提高病人的满意度。     

YYX型一次性吸氧装置的临床应用

[目的]了解YYX型一次性吸氧装置临床应用效果.[方法]将128例需要吸氧的病人随机分为观察组和对照组,每组64例,观察两组氧气湿化效果、湿化噪声、湿化瓶细菌培养阳性率和吸氧装置准备时间.[结果]观察组与对照组湿化效果相似;观察组无一例病人主观感受到湿化噪声,对照组有明显湿化噪声;观察组湿化瓶细菌培养阳性率显著低于对照组(P＜0.01);观察组吸氧准备时间显著少于对照组.[结论]YYX型一次性吸氧装置在有效保证湿化效果的情况下能杜绝吸氧过程中的细菌感染与病人交叉感染、消除气泡噪声、节省准备时间,是一种可靠、方便的临床选择.     

DSG一次性吸氧管在基层医院心内科的应用

[目的]探讨DSG一次性吸氧管在基层医院心内科应用的可行性,为临床选择合适的氧疗方式提供依据。[方法]将符合研究条件的100例在基层医院心内科住院且需要持续吸氧7d以上的病人,随机分观察组和对照组,观察组使用DSG一次性吸氧管吸氧,对照组使用常规湿化瓶吸氧,比较两组氧气湿化瓶细菌污染情况、病人满意度、直接护理时数。[结果]观察组氧气湿化瓶染菌量少于对照组（P〈0．01）,吸氧噪声少于对照组（P〈0．05）,除氧气异味项外其他咽喉舒适度均明显高于对照组（P〈0．05或P〈0．01）,对照组每天更换湿化瓶、湿化液和处理污染湿化瓶耗时25．23min±1．56min,观察组不需要更换湿化瓶和湿化液,节省了执行氧疗的时间。[结论]DSG一次性吸氧管在基层医院心内科使用,有利于降低湿化瓶细菌污染情况,减少工作量、吸氧噪声,提高病人的满意度。     

无湿化中低流量鼻道管持续吸氧在ICU患者中的应用

目的探讨无湿化中低流量鼻道管吸氧在重症监护室(intensive care unit,ICU)患者中的应用效果。方法将400例在ICU住院,需要持续中低流量吸氧24h以上的患者,随机分为实验组和对照组,每组各200例。实验组患者使用干燥湿化瓶直接吸氧,对照组患者使用湿化瓶吸氧。比较两组患者吸氧24h后呼吸道反应,湿化瓶细菌污染,患者对吸氧噪声反映情况及护士更换湿化瓶所需时间。结果两组患者氧疗后不适症状与各项指标比较,差异无统计学意义(均P0.05);两组患者湿化瓶细菌污染情况、患者感觉噪声、护士更换湿化瓶所需时间比较,均P0.05或P0.01,实验组细菌污染阳性率明显低于对照组,患者感觉吸氧噪声情况明显少于对照组,护士更换湿化瓶时间明显短于对照组。结论中低流量患者采用无湿化吸氧有利于降低湿化瓶细菌污染情况,减少工作量及吸氧噪声,值得临床推广应用。     

新型一次性氧气湿化输送装置的临床应用

[目的]探讨一种新的输氧装置(一次性氧气连接湿化瓶)是否优于传统的氧气湿化方法.[方法]将150例吸氧病人随机分为实验组和对照组,实验组应用一次性使用氧气连接湿化瓶,对照组应用蒸馏水湿化法,对正在使用的两种湿化液样本,分别在使用24 h、72 h、7 d进行细菌菌落数检测,并询问两组病人对湿化噪声的主观感受.[结果]实验组使用7 d内总合格率为100.0%,明显优于对照组(P<0.05);使用传统湿化装置的病人,48.0%病人明显感受到湿化噪声,而使用一次性氧气连接湿化瓶的病人,无一例感受到湿化噪声(P<0.05).[结论]一次性氧气连接湿化瓶比传统的湿化法更实用、更快捷,实现了无菌、无噪声、舒适安全吸氧.     

一次性吸氧管保护装置的制作与应用

鼻塞导管吸氧法是输氧管及其垂直连通且相互平行的鼻插管构成的吸氧装置.鼻插管放于鼻前庭内,并与鼻腔紧密接触吸氧.目前临床使用鼻塞导管为一次性材质,每3天更换1次.间断吸氧患者吸氧停止摘下吸氧管后,鼻插管处如不精心管理易造成污染.为此,我们设计了一次性吸氧管保护装置-H型套管.     

一次性除菌吸氧管在氧疗病人中的应用效果观察

[目的]探讨一次性除菌吸氧管在氧疗病人中的应用效果。[方法]将需持续低流量吸氧的病人200例随机分为观察组和对照组各100例,观察组使用一次性除菌吸氧管,对照组使用传统吸氧装置,比较两组湿化液中细菌培养的阳性率以及两组病人湿化噪音及吸氧异味的主观感受。[结果]观察组湿化液中细菌培养的阳性率低于对照组,观察组湿化噪音及吸氧异味的主观感受均低于对照组,差异有统计学意义。[结论]一次性除菌吸氧管能有效防止氧疗过程中的细菌污染,减少医院内呼吸道感染的风险,降低吸氧过程中的噪音及异味,提高了氧疗的安全性及氧疗病人的舒适度,值得临床推广应用。     

单人单用高压氧舱通氧管道对降低管道内细菌污染的效果观察

目的观察单人单用高压氧舱通氧管道内细菌污染的效果。方法采用方便抽样法选取2009年9-11月某院需进行高压氧治疗的56例患者,将其按随机数字表法分成对照组和观察组,每组28例。对照组患者面罩专用,Y型管、吸氧管、排氧管共用;观察组患者面罩、Y型管、吸氧管、排氧管全部单人单用。两组患者分别于治疗的第2、4、6、8、10天检测通氧管道内细菌污染情况。结果两组患者共采集280份标本,其中阳性标本为92份,占32.9%。对照组共检测出68份阳性标本,阳性标本检出率为48.6%;观察组共检出24份阳性标本,阳性标本检出率为17.1%,两组患者在阳性标本检出情况上差异有统计学意义（χ2=32.02,P〈0.05）。对照组标本中金黄色葡萄球菌的阳性率为16.4%,凝固酶阴性葡萄球菌的阳性率为21.4%,革兰阴性杆菌的阳性率为10.7%;观察组标本中凝固酶阴性葡萄球菌的阳性率为17.1%,未检出金黄色葡萄球菌和革兰阴性杆菌。两组患者治疗的第2、4、6、8、10天,总阳性标本检出率分别为13.0%、19.6%、21.7%、23.9%及21.7%。观察组患者前3d未出现细菌污染。两组患者不同时间的阳性标本检出率差异有统计学意义（P〈0.05）。结论建议高压氧治疗患者的通氧管道单人单用,并于4d后加强消毒,以有效控制院内感染。     

新型一次性湿化吸氧管对降低院内感染的影响

目的:在急诊工作中,通过改进吸氧治疗中的湿化液降低下呼吸道感染率。方法:将300例吸氧患者随机分为观察组和对照组各150例,分别使用含新型抑菌剂ε—聚赖氨酸的一次性湿化吸氧管及常规灭菌注射用水。对两组湿化液细菌污染情况、下呼吸道感染率进行统计分析。结果:观察组发生下呼吸道感染3例,对照组发生下呼吸道感染12例,经比较有统计学意义(P<0.05)。观察组湿化瓶细菌污染情况明显低于对照组(P<0.05)。结论:使用含生物抑菌剂ε-聚赖氨酸湿化液的一次性湿化吸氧管能有效降低因吸氧引起的下呼吸道感染。     

The relationship between oxygen demand,oxygen uptake,and oxygen supply

Results of the relationships between oxygen supply, demand, and uptake can be used to interpret cardiac output values, identify types of acute circulatory failure, guide attempts to improve cellular function, and thus prevent the development of multiple organ failure and death. Five steps in the interpretation of cardiac output values are recommended: (1) relate cardiac output to the patient's size; (2) determine the presence of anemia or hypoxemia; (3) measure mixed venous O₂ saturation and (4) blood lactate levels; and (5) evaluate O₂ uptake before and after a transient increase in cardiac output.     

The relationship between oxygen demand, oxygen uptake, and oxygen supply

Results of the relationships between oxygen supply, demand, and uptake can be used to interpret cardiac output values, identify types of acute circulatory failure, guide attempts to improve cellular function, and thus prevent the development of multiple organ failure and death. Five steps in the interpretation of cardiac output values are recommended: (1) relate cardiac output to the patient's size; (2) determine the presence of anemia or hypoxemia; (3) measure mixed venous O₂ saturation and (4) blood lactate levels; and (5) evaluate O₂ uptake before and after a transient increase in cardiac output.     

Regional oxygen delivery in oxygen supply-dependent states

Assessment of the adequacy of systemic O₂ delivery (DO₂) is central in the evaluation of critically ill patients, but estimates of systemic DO₂ do not assess the effectiveness of regional DO₂ to all vascular beds whose functions may require different degrees of blood flow depending on their metabolic and functional demands. The oxygen supply-consumption curve includes a supply-in-dependent portion, which represents the reserve capacity of the body to maintain oxygen consumption (VO₂) despite inadequate increases in DO₂, and a supply-dependent portion, which represents the physiologic adaptation that occurs once DO₂ is unable to meet the metabolic demands of the body. Experiments in dogs revealed that when systemic DO₂ was progressively reduced, blood flow was maintained in the vital organs (heart and brain) and redistributed away from the kidneys and liver, enhancing the ability of the whole organism to use oxygen efficiently. Disease states and iatrogenic conditions that alter this vasoregulatory process may directly impair organ system function.     

改良输氧装置结构对氧疗患者吸氧效果的影响

目的 探讨采用改良后输氧装置结构干燥吸氧患者吸氧效果的影响.方法 改良输氧装置结构,将80例需吸氧的病例按入院先后顺序单双号随机分成改良组和非改良组各40例,改良组使用改良后输氧装置干燥吸氧,非改良组使用传统的输氧装置,分别比较2组患者在吸氧前、吸氧30 min后、2 h后的呼吸、心率、血氧饱和度变化,采用独立样本t检验和配对t检验.结果 2组患者的呼吸、心率、血氧饱和度等方面无显著差异.结论 采用改良后的输氧装置干燥吸氧不会影响氧疗患者吸氧效果,避免了传统输氧装置的湿化瓶、湿化液、湿化瓶通气管等结构的污染问题及消毒程序复杂等问题.

Abstract：

Objective To discuss the effect of the modified structure of oxygen equipment on oxygen inhalation effect of patients receiving oxygen therapy.Methods The structure of oxygen equipment was modified.and 80 patients who required oxygen therapy were divided into the modified group and the non-modified group according to odd and even number of hospital admission sequence randomly with 40 patients in each group.The modified group used the modified oxygen equipment,the non-modified group used traditional one.The differences of respiration,heart rate and blood oxygen saturation rate between the two groups before oxygen inhalation,30 minutes and 2 hours after oxygen were compared.Results There was no significant difference in the respiration,heart rate and blood oxygen saturation rate between the two groups.Conclusions The modified oxygen equipment doesn't affect the oxygen therapy effect of patients,besides,it avoids the problems of pollution and the complicated disinfection procedure of the structure of the humidifier bottle,fluid and breathing vessel of the traditional equipment.     

医用氧气袋氧气流量调节控制器的研制

氧气袋是一长方形橡胶枕,枕的一角有一橡胶管,上有调节器可调节流量,氧气袋充入氧气,接上湿化瓶即可使用,此法可用于家庭氧疗、危重病人的抢救或转运途中,以代替氧气装置[1].     

Conjunctival oxygen tension and its relationship to arterial oxygen tension

Using a miniaturized Clark electrode embedded in a polymethylmethacrylate eyepiece, we measured transconjunctival oxygen tension (PcjO₂) in 5 healthy volunteer subjects at multiple levels of steady-state isocapnic hypoxia, normoxia, and hyperoxia. PcjO₂ was linearly related to arterial oxygen tension (PaO₂) as PaO₂ ranged from 28 to 205 mm Hg (PcjO₂=0.59 PaO₂+0.36 mm Hg;r=0.94; standard error of the estimate=7.09 mm Hg). However, the relationships between PcjO₂ and PaO₂ varied significantly among subjects. Whereas the overall mean ratio of PcjO₂ to PaO₂ was 0.59, the mean ratio for subjects ranged from 0.47 to 0.79 and was significantly different among subjects (P<0.0001). The time response of the electrode to a step change in oxygen tension in vitro was exponential, with a 90% response time of 38 seconds after a lag of 3.7 seconds. The time responses to in vivo changes in oxygen tension were also exponential. From hypoxia to normoxia, 90% response time was 45.0 seconds after a lag of 5.1 seconds; from room air to hypoxia, 90% response time was 72.4 seconds after a lag of 30.3 seconds; from room air to hyperoxia, 90% response time was 87.2 seconds after a lag of 6.8 seconds. We conclude that, although PcjO₂ measured by a miniaturized Clark electrode is linearly related to PaO₂ in healthy subjects, variation in the relationship of PcjO₂ to PaO₂ among individuals will prevent precise estimation of PaO₂ for any individual unless subject-specific calibration is performed.     

氧气流量表及吸氧管收纳防尘套

病人吸氧后需要将流量表和吸氧管收起,护理人员多采用外包装袋将吸氧管装入后用胶布包裹,间断吸氧病人的吸氧管常挂在流量表上,这样吸氧管和流量表会受到灰尘污染,不符合医院感染控制要求。为此,我们设计了一款收纳防尘套,现介绍如下。     

一次性鼻氧管接头在氧气装置中的应用

临床护理工作中要求氧气装置（包括氧气筒及中心供氧装置）处于备用状态时,应将氧气出口处接头密封保护。以前一般采用橡胶引流管剪断后,将一端打折用胶膏固定封闭,另一端开放,并将索线系紧后挂于氧气装置上进行密封。另一种方法是用引流袋接头帽钻孔后,前者长时间使用后索线易断,且橡胶管用一段时间后也会破损;     

Transtracheal oxygen delivery

Tracheal insufflation of oxygen has at least three major uses for chronic oxygen supplementation through a percutaneous catheter, it is an adjunctive measure to enhance gas exchange during mechanical ventilation, and it provides an emergency therapy for oxygen delivery with upper airway obstruction. In this article the mechanisms of gas exchange and techniques of oxygen delivery are described for each of these major uses.