丁勇 梁松梅 唐冬梅 何静（上海市杨浦区殷行社区卫生服务中心 上海 200438）

家用加湿器在社区气管切开患者吸痰前湿化效果的研究

丁勇 梁松梅 唐冬梅 何静
（上海市杨浦区殷行社区卫生服务中心 上海 200438）

摘 要目的：研究家用加湿器对社区长期气管切开患者吸痰前湿化的效果。方法：将气管切开患者26例分为干预组14例和对照组12例，干预组吸痰前用家用加湿器湿化，对照组给予常规吸痰前湿化。两组在干预前后分别测量心率、血压、呼吸、血氧饱和度、有无咳嗽反射以及痰液黏稠度等各项指标，比较两组患者吸痰前后的各方面生理指标。结果：两组患者在生理指标（心率、血压、呼吸、血氧饱和度）上差异无统计学意义（P>0.05），但干预组的痰液稠度及咳嗽反射明显好于对照组，差异有统计学意义（P<0.05)。结论：家用加湿器用于人工辅助湿化效果较好。

关键词气管切开 家用加湿器 吸痰 湿化

Research on the humidification effect of the household humidifier before the sputum suction on the patients with their tracheotomy in the community

DING Yong, LIANG Songmei, TANG Dongmei, He Jing
(Yinghang Community Health Service Center of Yangpu District, Shanghai 20438, China)

ABSTRACTObjective: To study the humidification effect of the household humidifier before the sputum suction on the patients with their tracheotomy for a long time in the community. Methods: The 26 patients with tracheotomy were divided into an intervention group with 14 cases and a control group with 12 cases. Before the sputum suction, the former was humidified by the household humidifier while the latter conventionally humidified. The heart rate, blood pressure, breathing, blood oxygen saturation, presence of cough reflex, sputum viscosity and index of two groups were detected before and after the intervention, respectively, and their various physiological indexes were compared. Results: There is no statistical significance in the physiological indexes ( the heart rate, blood pressure, respiration, blood oxygen saturation) in the patients of the two groups (P>0.05), but the viscosity and sputum cough reflex of the intervention group was obviously better than those of the control group, which enjoyed the statistical significance (P<0.05). Conclusion: The good effect is achieved when household humidifier is used as artificial supplementary humidification .

KEY WORDStracheotomy; household humidifier; sputum suction; humidification

气道湿化是气管切开术的重要环节，由于人工气道的建立使上呼吸道正常湿化、加温、过滤及咳嗽功能消失，容易导致气道内黏膜假复层柱状上皮和立方上皮的破坏和扁平化，细胞变性、脱落，气道损伤后反应性充血，最终导致黏膜纤毛清除功能受损、小气道塌陷、肺不张，同时由于咳嗽反射受抑制，分泌物滞留在支气管中，可导致肺泡表面活性物质减少，肺顺应性下降，而诱发肺部感染[1]。随着医学发展，脑死亡已成判断死亡的标准[2]。很多患者仍然可以通过人工气道方法维持呼吸、延长生命。越来越多建立人工气道患者进入康复医院进行治疗及康复，吸痰术在人工气道患者护理上应用较多，而吸痰是否有效取决于吸痰前的湿化。所以……