摘要
目的比较两种人工气道湿化方法对脑创伤气管切开患者的效果。方法选择2012年1月—2012年8月在我科行脑创伤气管切开患者75例,并将其按住院号(单双号)分为氧气雾化吸入组(38例)和人工鼻组(37例)。比较两组患者在气道湿化、痰痂形成、气道出血、痰培养阳性、气管套管堵塞方面的差异。结果氧气雾化吸入组的痰痂形成率、气道出血率及湿化不足发生率均低于人工鼻组(P<0.05);肺部感染率高于人工鼻组(P<0.05);其余观察指标发生率比较,差异均无统计学意义(P>0.05)。人工鼻组中发生气管套管堵塞2例,给予更换气管套管后使用氧气雾化吸入方式湿化;且7例痰痂形成、13例气道出血及6例湿化不足患者均更换使用氧气雾化吸入进行气道湿化,使用后痰痂形成、气道出血均明显好转,更换气管套管后患者未再发生气管套管堵塞。结论氧气雾化吸入与人工鼻对脑创伤气管切开患者均有良好的气道湿化效果,氧气雾化吸入组在气道湿化满意度上优于人工鼻组,但存在痰液细菌培养阳性率比较高的缺点,故在临床使用中要有针对性地选择气道湿化方式,进行个体化管理。
Objective To compare 2 humidifying methods in cerebral wound patients after tracheotomy. Methods Seventy - five post - trachcotomy cerebral wound patients admitted to this hospital from January to August 2012 were divided, ac- cording to hospital number （ odd or even numbers ）, into groups A （ given oxygen inhalation, n = 38 ）, B （ given artificial nose, n = 37）. The difference in airway humidification, sputum scab formation, airway bleeding, positive sputum culture, en- dotracheal tube blockage were compared between 2 groups. Results The rates of sputum scab formation, airway bleeding and incidence of insufficient humidification were lower in group A than in group B （P 〈 0. 05 ）, and lung infection rate higher （P 〈 0. 05 ） ; there was no significant difference in the other indicators between 2 groups （P 〉 0.05 ）. In group B, 2 had endotrache- al tube blockage and given humidifying of oxygen inhalation after the replace of tracheal tube. Seven had sputum scab formation, 13 had airway bleeding and 6 had insufficient humidification, sputum scab formation obtained and airway bleeding improved after oxygen inhalation, no tracheal tube blockage occurred after replace of tracheal tube. Conclusion Oxygen aerosol inhalation and article nose are both effective for airway humidification in post - tracheotomy cerebral wound patients. The satisfaction of airway humidification of group A is superior to that of group B, but it has the disadvantage of high positive rate of sputum bacterial cul- ture. So airway humidification method should be chosen purposefully in clinical uses.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第2期226-228,共3页
Chinese General Practice
