改进吸痰法在气管插管机械通气患者中的应用效果观察

目的探讨改进吸痰法在气管插管机械通气患者中的应用效果观察。方法将行气管插管机械通气的120例患者,按照随机数字表法分为试验组和对照组,每组各60例,试验组采用改进吸痰法,包括气管导管内（浅部）吸痰、气管导管外（深部）及气囊上方吸痰3部分;对照组采用常规吸痰法。两周后观察两组患者气道黏膜损伤及呼吸机相关性肺炎（ventilator-associated pneumonia,VAP）的发生情况。结果试验组和对照组患者气道黏膜损伤发生率比较,差异具有统计学意义（1.7%vs16.7%,χ2=8.107,P〈0.01）;试验组和对照组患者VAP的发生率比较,差异具有统计学意义（3.3%vs18.3%,χ2=6.988,P〈0.01）。结论改进吸痰法在气管插管机械通气患者中的应用,不仅降低了患者气道黏膜的损伤,同时还降低了VAP的发生,值得临床推广应用。

Effect of improved suction on patients undergoing mechanical ventilation via tracheal incubation

Objective To investigate the effect of improved suction on patients undergoing mechanical ventilation via tracheal incubation.Methods One hundred and twenty ICU patients undergoing mechanical ventilation via tracheal incubation were divided into the experiment group and the control group by the randomized digital table,60 patients in each group.The experiment group received the improved suction which included superficial suction in the tracheal tube,deep suction outside the tracheal tube and suction in the upper balloon.The control group received the conventional suction.Then we observed the incidence of airway mucosa damage and ventilator-associated pneumonia across the two groups after two weeks.Results The incidence rate of airway mucosa damage was 1.7% in the experiment group,which was significantly lower than that of 16.7% in the control group（χ2=8.107,P 0.01）.The incidence of ventilator-associated pneumonia was 3.3% in the experiment group,which was significantly lower than that of 18.3% in the control group（χ2=6.988,P 0.01）.Conclusions The improved suction may not only decrease the damage of airway mucosa,but also reduce the incidence of ventilator-associated pneumonia.Therefore,it’s worthy of clinically spreading.