不同呼吸机湿化管道系统护理成本分析

目的 比较3种不同呼吸机湿化管道系统的护理成本。方法 选择建立人工气道机械通气48h以上患者90例，随机分为3组，每组各30例。无加热丝组使用MR410型湿化管道系统，吸气与呼气管路均无加热丝；单加热丝组使用MR730型湿化管道系统，吸气管路带加热丝而呼气管路无加热丝；双加热丝组采用MR850型湿化管道系统，密闭式一次性、双加热式自动加水、加湿；3组均使用统一厂家的呼吸机和湿化液（灭菌注射用水）。分析比较3组的护理成本：观察每组维护呼吸机湿化管道系统的护理时数，计算护理人力成本、护理耗材成本及处理并发症（气道痉挛、气道湿化不足及湿化过度）形成的护理成本。结果3组呼吸机管道更换、添加湿化液、倾倒冷凝液、并发症处理护理时数经比较，差异有统计学意义（P〈O．05），双加热丝组的各项护理时数均少于无加热丝组和单加热丝组（P〈O．05）。3组呼吸机湿化管道系统的护理人力成本、其他成本及合计总成本的差异有统计学意义（P〈0．05），双加热丝组护理总成本最低（2313．2±150．7）元，例]，无加热丝组护理总成本最高（7924．5±1522．7）元／例]。护理耗材成本3组差异无统计学意义（P〉0．05）。结论 MR850型密闭式一次性双加热式、自动加水加温呼吸机湿化管道系统护理成本低，使用方便，可节省人力。

Analysis of Care Costs of Tube-humidifying Systems in Different Breathing Machines

Objective To compare the care costs of tube-humidifying systems in three different breathing machines. Methods 90 subjects with artificial airway machine ventilation for more than 48 hours were equally randomized into 3 groups： non-heating wire group, single heating wire and double heating wire group, where MR410 tube-humidifying system without heating wires, MR 730 with heating wire only in respiration tube and MR 850 with heating wires both in the respiration tube and breathing tube were used respectively. The breathing machines and humidifying solutions from the same factory were used in all the groups. The durations for caring the machines were recorded, the care costs as well as the costs for consumed articles and the costs for treating the complications （air duct spasm, poor airway humidification or over-humidification） were computed. Results Statistically, the differences were significant in respect of tube alteration, addition of fluid, disposal of condensate and hours for complication management between the three groups （P〈0.05）. The hours for care in the group of double heating wire were fewer than those in the other two groups（P〈0.05）. The costs for care, other costs and the total costs were statistically different among the three groups （P〈0.05）, the lowest in the group of double heating wire （2 313.2±15.7 yuan/case） and the highest in the group of non-heating wire （7 924.5±1 522.7 yuan/ease）. No statistical differences were found in care-consumed articles among the groups （P〉0.05）. Conclusion MR 850 breathing machine with double-heating wires is low at cost, convenient in use, labor-saving, thus lowering the medical total care cost.