使用人工鼻联合持续气道湿化技术湿化液量探讨

目的探讨不同气道湿化量对使用人工鼻联合持续气道湿化技术机械通气患者的影响。方法将我院重症医学科80例使用人工鼻联合持续气道湿化技术的机械通气患者随机分为两组,其中,观察组40例通过评估病人痰液情况随时调整湿化量,痰液黏稠度Ⅰ度以2～4ml/h、Ⅱ度以4～6ml/h、Ⅲ度以6～8ml/h的速率泵入;对照组40例直接以2ml/h的速率泵入湿化,对两组患者的湿化效果、气道黏膜出血、痰痂形成情况、刺激性咳嗽、呼吸机相关性肺炎(VAP)的发生率、导管更换频次、平均每例每天吸痰次数进行对比。结果观察组湿化效果好,气道黏膜出血、痰痂形成情况、导管更换频次、平均每例每天吸痰次数减少,刺激性咳嗽、呼吸机相关性肺炎的发生率低,差异有显著意义(P<0.05)。结论机械通气患者采用人工鼻联合持续气道湿化技术,通过评估痰液黏稠度,及时调整湿化量,保证了人工气道的湿化效果,有利于预防并发症的发生,有效降低了医院感染的发生率。

Study of the humidification fluid volume by artificial nose combined continuous airway humidification

Objective To study the different airway humidification quantity on the use of artificial nasal combined continuous airway humidification technology for patients with mechanical ventilation. Method 80 cases patients with artificial nose combined continuous airway humidification techniques of mechanical ventilation were randomly divided into two groups. Based on patient＇s sputum viscosity adjustment humidification quantity, The humidification fluid of 2-4 ml/h, 4-6 ml/h and 6-8 ml/h were given in the observation group in 40 cases. The humidification fluid of 2 ml/h rate was given directly in control group comparative analysis of two groups of humidification, airway mucosal bleeding. The phlegm scab formation, irritating cough, ventilator-associated pneumonia（VAP）, incidence of cathe- ter replacement frequency and average sputum suction per day was observed and compared. Result The observation group humidification effect is good, the airway mucosal bleeding, the phlegm scab formation, catheter replacement frequency and reducing in the number of sputum suction, irritating cough, ventilator-associated pneumonia incidence was significant lower than that of control group （P~0.05）. Conclusion Through the evaluation of sputum viscosity and timely adjustment of humidification quantity and guarantees the artificial humidification effect is conducive to the prevention of associated complications, effectively prevention the associated complications, effectively reducing the incidence rate of hospital infection, reduce the suffering of patients, reduce the nursing workload, improve the quality of medical care, it is worthy of clinical application.