气管切开导管气囊上滞留物引流对危重患者医院获得性肺炎发病的影响

目的：观察气管切开导管气囊上可吸引滞留物对重症治疗病房（ICU）患者医院获得性肺炎（HAP）的发病、成本及预后的影响。方法：入选我院ICU2004年5月-2006年5月气管切开危重患者120例，将其随机分为两组，气囊上滞留物引流（Subballonet secretion drainage，SSD）组60例，对照组（未引流组）60例，记录发生医院内获得性肺炎的时间、细菌培养的结果，气管切开气道开放时间，ICU住院天数。结果：气囊上滞留物与下呼吸道病原体有一致性和相似的构成比，SSD组院内感染肺炎发生率明显低于对照组。结论：持续气囊上滞留物引流可以明显降低ICU气管切开危重患者院内感染肺炎发生率，减少气道开放时间，相应的也减少ICU的住院时间，降低总住院时间及死亡率。

Influence of subglottic secretion drainage on the onset of hospital acquired pneumonia in intensive care patients underwent tracheostomy

Objective To research the influence of subglottic secretion drainage onincidence, cost and prognosis of hospital acquired pneumonia (HAP) in intensive care patients underwent tracheostomy. Method For 120 intensive care patients underwent tracheostomy during May 2004 to May 2006 were divided into two groups randomly, and group A (n=60) with continous subglottic secretion draining and group B (n=60)with normal tracheotomy tube. The beginning time, bacterial culture results, trachea opening time and staying time in ICU of HAP were recorded. Results Pathogen of subglottic secretion drainage was similar to that of lower respiratory secretion, and group A had a lower incidence rate of HAP compared with group B. Conclusion Continous subglottic secretion draining can decrease the incidence rate of HAP in intensive care patients underwent tracheostomy, also reduce trachea opening time, ICU staying time, hospitalization time and mortality rate.