人工气道持续氧雾化湿化的临床应用研究

[目的]观察持续氧雾化人工气道湿化在重型颅脑损伤、脑出血行气管切开病人中的临床应用效果。[方法]将92例重型颅脑损伤、脑出血行气管切开、气管插管病人随机分为观察组和对照组，每组46例，观察组采用持续氧雾化温化法和对照组采用持续滴注湿化法。观察并比较两组病人气道湿化效果。[结果]观察组病人痰液黏稠度明显低于对照组（P〈0．05）；观察组气道湿化并发症发生率（包括刺激性咳嗽、痰栓形成、气道黏膜损伤出血、肺部感染）明显低于对照组（P〈0．05）；与对照组比较，观察组病人血氧分压（PaO2）、血氧饱和度（SaO2）明显升高，心率、呼吸频率明显减慢（P〈0．05）。[结论]持续氧雾化人工气道湿化能安全、有效地提高重型颅脑损伤、脑出血行气管切开、气管插管病人的气道湿化效果。

Study on clinical application of artificial airway continuous oxygen atomization humidification

Objective. To observe clinical application effect of artificial airway continuous oxygen atomization humidification for patients with severe head injury or cerebral hemorrhage accepted tracheotomy. Methods. A total of 92 patients with severe head injury or cerebral hemorrhage accepted tracheotomy or tracheal canula were randomly divided into test and control group （n=46）. Patients of test group adopted continuous oxygen atomization humidification. Patients of control group adopted continuous dripping humidification. Effects of airway humidification of two group cases were observed and compared. Results. Sputum viscosity in test group patients was significantly lower than that in control group （P〈0. 05）. Incidence of airway humidification complications in test group （including irritating cough, sputum thrombus formation, airway mucosal injury and hemorrhage, pulmonary infection） was significantly lower than that in control group （P〈0.05）. Compared with control group,PaO2 and SaO2 of test group cases were significantly higher, heart rate and respiratory rate were significantly lower （P〈0.05）. Conclusion. Artificial airway continuous oxygen atomization humidification could safely and effectively enhance the effect of airway humidification for patients with severe head injury, cerebral hemorrhage accepted tracheotomy or tracheal canula.