贺丽琼　逯学梅　安　颖　白荣荣包头医学院第一附属医院呼吸科，内蒙古包头　014010

文丘里装置联合湿化器对昏迷患者气道湿化的效果研究

贺丽琼逯学梅安颖白荣荣
包头医学院第一附属医院呼吸科，内蒙古包头014010

目的探讨昏迷患者气管切开后行文丘里装置联合湿化对气道湿化的效果。方法选取2012年1月～2015年1月我院ICU因各种原因所致昏迷行气管切开的患者40例，随机分为对照组和实验组，每组各20例。实验组患者使用呼吸机湿化器联合文丘里装置进行气道湿化，对照组使用微量泵持续滴入对患者进行气道湿化，两组湿化液均使用灭菌注射用水。观察指标包括两组患者干咳的情况、痰液黏稠度、气道黏膜出血、气道痰痂及肺部感染的发生率。结果实验组较对照组在干咳、痰液黏稠度、气道黏膜出血、痰痂及肺部感染发生率方面均显著改善，差异具有统计学意义（P＜0.05）。结论对昏迷患者行气管切开后使用呼吸机湿化器联合文丘里装置可有效控制气道湿度，提高气道湿化效果，促进排痰，从而降低肺部感染发生率。

气管切开；气道湿化；湿化器；文丘里装置

［Abstract］Objective To investigate the effect of combined application of Venturiapparatus and Ventilator humidification device on airway humidification after tracheotomy in coma patients.M ethods 40 coma patients selected in ICU in our hospital from Jan.2012 to Jan.2015 were randomLy assigned control or experimental group，20 cases in each group.The reasons for coma in these 40 patients were various and all the patients were treated with tracheotomy，The experimental group was treated with Ventilator humidification device and Venturi apparatus to humidify airway，while the control group was treated with continuous airway instillation by micro pump.Sterilized saline was used in both groups for humidified fluid application.Observation indicator includes dry cough，sputum viscosity，airwaymucosa hemorrhage，sputum scab and the incidence of pulmonary infection.Results In the experimental group，the incidence of dry cough，sputum viscosity，airwaymucosa hemorrhage，sputum scab and the incidence of pulmonary infection were significantly improved.The difference was statistically significant（P＜0.05）.Conclusion The combined application of Ventilator humidification device and Venturi apparatus could improve the airway humidification effect and promote the excretion of sputum，therefore reducing the incidence of pulmonary infection.

［Key words］Tracheotomy；Airway humidification；Wet device；Venturiapparatus

昏迷是各种颅内或颅外病变导致的中枢神经系统发生高度抑制的病理状态，各种昏迷患者大多会收入重症监护病房（intensive care unit，ICU）。这些昏迷患者常因咳嗽反射消失等原因导致下呼吸道分泌物潴留，妨碍肺泡气体交换，从而出现呼吸衰竭的各种临床表现，危及患者生命。为了更有效地清除气道分泌物，维持气道的畅通，在ICU病房中经常会对患者施行气管切开术［1］。……