摘要
目的研究呼吸机加热湿化器的双伺服加热方式的临床应用价值。方法采用前瞻性随机对照研究方法,将应用加热湿化器的呼吸机治疗患者40例随机分成对照组、实验组各20例。对照组采用单伺服加热方式(即只有1个加热元件对湿化器的湿化水罐加热),实验组采用双伺服加热方式(即不仅对湿化器的湿化水罐加热,而且在呼吸机管道的吸气支路及呼气支路中均放置加热丝进行加热)。呼吸机治疗过程中,在密切监测两组的管道倾倒冷凝水量、管道护理次数、痰液黏稠度、气道形成痰痂例数及发生VAP例数至呼吸机治疗结束;在应用呼吸机治疗后的第0、8、16、24、32、40、48、56、64、72h监测两组气道峰压(Ppeak)、平台压(Pplat)、平均压(Pmean)、气道阻力(Raw)等呼吸力学指标。结果实验组管道倾倒冷凝水量、管道护理次数、Ⅲ度痰液黏稠度例数、气道形成痰痂例数及发生VAP例数明显小于对照组(P<0.05)。实验组Ppeak、Pplat、Pmean及Raw较对照组明显下降(P<0.05)。结论呼吸机加热湿化器采用双伺服加热方式比单伺服加热方式的湿化效果更好,能为呼吸机治疗患者提供最佳湿化的气体,以利于保持分泌物良好的水化状态,降低VAP发生率,减少呼吸机管道护理工作量,降低气道压力及阻力。
Objective To evaluate the clinical value of dual-servo-heated method for heated humidifier of ventilator. Methods By taking the foreseeing stochastic comparative method,40 cases treated by ventilator were randomly divided into control group and ex- perimental group （n=20）. Single-servo -heated method was used in control group （Only water chamber was heated by heated ele- ment）, however,dual-servo-heated method was used in experimental group （Not only water was heated, but also inspiratory tube and expiratory tube were heated by wire）. During ventilation, some indicators were observed including： disposal of condensate, tube alteration, sputum viscosity, formation of sputum callus, and cases of ventilator-associated pneumonia （VAP）. Furthermore, respira- tory mechanics indicators were also monitored including： peak airway pressure （Ppeak）, plateau pressure （Pplat）, mean pressure （Pmean） ,airway resistance （Raw） from the beginning of using ventilator at 0,8,16,24,32,40,48,56,64,72h. Resullts The num- ber of disposal of condensate, tube alteration, 3 degree in sputum viscosity, formation of sputum callus and VAP in experimental group was significantly less than those in control group（P〈0.05）. Ppeak,Pplat,Pmean,Raw in experimental group were all signif- icantly less than that in control group（P〈0.05）. Conclusion Dual-servo-heated method is better than single-servo-heated method for heated humidifier,which can provide the best of gas humidity and maintain good secretions hydration and lower incidence of VAP. Furthermore, the pressure and resistance of airway are reduced,and the nursing workload is saved.
出处
《重庆医学》
CAS
CSCD
北大核心
2009年第20期2537-2539,共3页
Chongqing medicine
关键词
呼吸机
加热湿化器
双伺服加热
ventilator
heated humidifier
dual-servo-heated
