摘要
目的探讨不同湿化方式对不上机气管切开患者痰液性状的影响效果。方法选取2013年1月-2015年10月重庆市垫江县人民医院收治的行气管切开的患者54例，所有患者均未进行机械通气。采用随机数字表法将患者分为两组．观察组和对照组，每组各27例。观察组采用输液泵持续恒温湿化进行气道湿化；对照组采用间歇性人工气道内滴人常温湿化液进行气道湿化。治疗两周后，观察并比较两组患者的血氧饱和度及动脉血氧分压，比较两组的湿化效果，如痰痂形成、刺激性咳嗽、呼吸道黏膜出血、肺部感染及湿化程度。结果治疗后第3天，观察组1例患者感呼吸困难，予上呼吸机，退出本次研究。治疗两周后，观察组血氧饱和度[（97．6±17．1）％]、动脉血氧分压[（88．9±12．8）mmHg]均明显高于对照组[（92．2±11．5）％、（70．2±9．5）mmHg]，差异均有统计学意义（P〈0．05）；观察组痰痂形成（11．54％）、刺激性咳嗽（7．69％）、呼吸道黏膜出血（7．69％）、肺部感染（0．00％）发生率明显低于对照组（55．56％、48．15％、37．04％、22．22％），差异均有高度统计学意义（P〈0．01）；观察组湿化良好的Ⅱ度患者所占比例明显高于对照组（80．77％比37．04％），Ⅰ度患者明显少于对照组（7．69％比62．96％），Ⅲ度患者多于对照组（11．54％比0．00％），差异有高度统计学意义（P〈0．01）。结论持续恒温湿化法可有效降低不上机气管切开患者痰液的黏液度．气道湿化效果显著，值得临床上推广应用。
Objective To explore the different ways of wetting on the sputum traits of tracheotomy patients without me- chanical ventilation. Methods Fifty four patients with tracheotomy from January 2013 to October 2015 in People＇s Hos- pital of Dianjiang County were selected, all of the patients were without mechanical ventilation. According to the ran- dom number table method, patients were divided into observation group and control group, with 27 cases in each group. Patients of the observation group were given the airway moist through infusion pump continuously and constant temper- ature; patients of the control group were given the intermittent airway wetting by normal temperature drops through arti- ficial airway. Blood oxygen saturation and arterial blood oxygen partial pressure of patients in two groups 2 weeks after treatment were observed and compared; wetting effect such as sputum scab formation, irritating cough, respiratory tract mucous membrane bleeding, lung infection and degree of wetting of two groups were compared. Results 3 days after treatment, 1 patient of the observation group felt difficulty to breathing, and was given the breathing machine and out of this study. 2 weeks after treatment, blood oxygen saturation [（97.6±17.1）%], arterial blood oxygen partial pressure [（88.9± 12.8） mmHg] of the observation group was significantly higher than those of the control group [（92.2±11.5）%, （70.2± 9.5） mmHg], the differences were statistically significant （P 〈 0.05）; sputum scab formation （11.54%）, irritating cough （7.69%）, respiratory tract mucous membrane bleeding （7.69%）, incidence of pulmonary infection （0.00%） of the obser- vation group were significantly lower than those of the control group （55.56%, 48.15%, 37.04%, 48.15%）, the differ- ences were statistically significant （P 〈 0.01）; proportion of patients with Ⅱ degree good wetting in the observationgroup was significantly higher than that of the controlgroup （80.77% vs 37.04%）, and patients with Ⅰ degree was less than＇the control group （7.69% vs 62.96%）, patients with Ⅲ degree was more than the control group （11.54% vs 0.00%）, the difference was statistically significant （P 〈 0.01）. Conclusion Continuous and constant temperature airway humidification method can effectively reduce the sputum mu- cous degrees of tracheotomy patients without mechanical ventilation, effect of airway moist is remarkable, which is wor- thy of clinical application.
出处
《中国医药导报》
CAS
2016年第8期116-119,共4页
China Medical Herald
基金
重庆市医学科研计划项目(20143078)
关键词
气管切开
气道湿化
黏液度
持续性
间歇性
Trachea incision
Airway moist
Mucus degrees
Continuous
Intermittent
