持续呼吸机治疗呼吸机管道更换时间及频率探讨

目的探讨持续呼吸机治疗呼吸机管道更换时间及频率。方法选择70例呼吸机治疗持续超过lOd患者，分为两组，各35例，其中观察组使用双加热式呼吸机湿化管道系统，并且在每次使用前均进行有效的消毒灭菌，并且在治疗后第7天对管道进行更换，对照组仅使用双加热式呼吸机湿化管道系统，但不对管道进行特殊处理，比较两组患者发生呼吸机相关性肺炎的时间，72h不同部位采集样本微生物培养阳性情况及对呼吸机参数进行比较。结果观察组168h发生呼吸机相关性肺炎显著低于对照组（P〈0．05），咽峡部、下呼吸道、呼吸机管路及湿化器内采集样本微生物培养阳性率均显著低于对照组（P〈0．05），治疗后72h患者气道压峰值、平均气道压及气道平台压均显著低于对照组（P〈0．05）。结论使用双加热式呼吸机湿化管道系统连续使用7d后对管道进行更换，对预防和减少呼吸机相关性肺炎的发生率上有一定价值。

Discussion the time and frequency of continuous ventilation with ventilator pipe replacement

Objective To discuss the time and frequency of continuous ventilation with ventilator pipe replacement. Methods 70 cases of ventilator treatment lasted more than 10 clays were divided into two groups, each 35 cases, the observation group were used double heating type ventilator wet pipe system, and disinfected each time and in 7 days to replace the pipeline, the control group were only used double heating type ventilator wet pipe system, without the pipeline for special treatment, then ventilator-associated pneumonia in 72 hours, different parts of microbial culture positive samples of ventilator parameters were compared in the two groups. Results After 168h, the observation group with ventilator-associated pneumonia were lower than control group（P 〈 0.05）, isthmic portion, lower respiratory tract, the ventilator pipeline and humidifier samples of microbial culture positive rate were lower than control group（P 〈 0.05）, 72 hours after treatment with airway peak pressure, mean airway pressure and plateau airway pressure were lower than control group（P 〈 0.05）. Conclusion To replace the pipeline used continuously in 7 days witch using the double heating type ventilator wet pipe system can prevent and reduce the incidence of ventilator-associated pneumonia.