摘要
目的了解持续声门下吸引及间断声门下吸引在预防呼吸机相关性肺炎(VAP)中的作用。方法将收入我院重症监护病房(ICU)的296例行机械通气的患者随机分为3组,常规气管插管组为对照组,带声门下吸引的气管插管组为实验组,实验组中分为持续声门下吸引组及间断声门下吸引组;记录各组机械通气时间、发生VAP的时间,VAP发生率,急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ评分),病死率及痰培养等。结果机械通气患者在通气第6天VAP发生率分别为:持续声门下吸引组29.0%,间断声门下吸引组26.0%,对照组43.5%,对照组与实验组比较差异有统计学意义(P<0.05),持续声门下吸引组与间断声门下吸引组比较无统计学意义;但第7天VAP发生率分别为:持续声门下吸引组39.0%、间断声门下吸引组38.5%、对照组48.9%,对照组与实验组比较无统计学意义。结论在短期插管(<7天)机械通气的患者中应用声门下吸引有预防VAP的作用。采用持续声门下吸引方式与每2小时进行1次的间断声门下冲洗方式能得到相似的预防VAP的效果。
Objective To determine whether the application of aspiration of subglottic secretions （ASS） is associated with a decreased incidence of ventilator-associated pneumonia （VAP）. Methods Two hundred ninety-six patients undergoing mechanical ventilation were randomized into three groups： received continuous aspiration of subglottic secretions （CASS group）, received intermittent aspiration of subglottic secretions （IASS group） and received routine endotracheal tube （control group） respectively. Days of mechanical ventilation,the time of the onset of VAP, APACHE Ⅱ score,mortality and bacteria isolated from the tracheal aspirates were obtained. Results The incidence rate of VAP in the sixth day was 29.0% in CASS group 26.0% in IASS group 43.5% in control group, There were statistically significant difference between ASS group and control group （P 〈 0.05）. There were no statistically significant difference between CASS group and IASS group（ P 〉0.05）. Conclusion ASS application of aspiration of subglottic secretions can effectively prevent VAP in the early stage of less than seven days. There is the same effect between CASS group and IASS group.
出处
《临床荟萃》
CAS
北大核心
2008年第21期1539-1542,共4页
Clinical Focus
关键词
肺炎
呼吸机相关性
导管插入术
外周
重症监护病房
pneumonia, ventilator-associated
catheterization, peripheral
intensive care units
