邱淑花 黄毓东 张雄英 刘云阁

[摘要]目的 探讨密闭型双加热丝呼吸机管道湿化模式在机械通气患者中的应用效果。方法 选取2017年7月～2018年12月我院收治的进行机械通气的80例患者作为研究对象，采用随机数字表法分为实验组和对照组，每组各40例。实验组患者给予密闭型双加热丝呼吸机管道湿化模式，对照组患者给予普通型无加热丝呼吸机管道湿化模式。观察治疗过程中，两组患者呼吸机相关性肺炎的发生率以及管道护理相关方面的指标。结果 实验组患者机械通气第14、21、28天的呼吸机相关性肺炎发生率均低于对照组，差异有统计学意义（P<0.05）;两组患者的通气时间比较，差异无统计学意义（P>0.05）;实验组患者的管道更换次数、倾倒冷凝水量少于对照组，管道使用时间长于对照组，每日呼吸机管道护理时数短于对照组，差异均有统计学意义（P<0.05）。结论 临床上，应用双加热丝密闭式呼吸机湿化管道模式较普通型无加热丝呼吸机管道湿化模式，降低了呼吸机相关性肺炎发生率，更符合人体需求，并保证了湿化质量，更符合临床要求。

[关键词]呼吸机;肺炎;管道湿化模式;效果分析

[中图分类号] R563.1          [文献标识码] A          [文章编号] 1674-4721（2019）6（c）-0051-04

[Abstract] Objective To investigate the application effect of the closed double-heated ventilator pipeline in humidification mode in mechanical ventilation patients. Methods Eighty patients applied with mechanical ventilation treated in our hospital from July 2017 to December 2018 were selected as the subjects， and divided into experimental group and control group by a random number table method， with 40 cases in each group. In the experimental group， a closed double-heated ventilator pipeline in humidification mode was used， while in the control group， normal-type non-heated ventilator pipeline in humidification mode was adopted. During the treatment， the incidence of ventilator-associated pneumonia and indicators related to pipeline nursing were observed between the two groups. Results The incidence of ventilator-associated pneumonia in the experimental group were significantly lower than those in the control group on days 14， 21 and 28 （P<0.05）. There was no significant difference in ventilation time between the two groups （P>0.05）. The frequency of pipeline replacement and amount of condensate water dumping in the experimental group were both less than those in the control group， the pipeline usage was longer than that in the control group， and the daily ventilator pipeline nursing time was shorter than that in the control group， and the differences were statistically significant （P<0.05）. Conclusion Clinically， the closed double-heated ventilator pipeline in humidification mode significantly reduces the incidence of ventilator-associated pneumonia meeting patients′ need， and ensures the quality of humidification in line with clinical requirements compared with normal-type non-heated ventilator pipeline in humidification mode.

[Key words] Ventilator; Pneumonia; Pipeline humidification mode; Effect analysis

呼吸機相关性肺炎（ventilator-associated pneumonia，VAP），即发生在机械通气过程中的院内获得性肺炎，常见于重症监护室内，是机械通气的常见临床并发症。在临床应用中，呼吸机使用频率与VAP的临床发生率成正比，且VAP临床治疗费用昂贵、治愈率低[1-2]。在临床中，引发VAP的因素有很多，其中机械通气与其具有直接联系[3]。机械通气治疗过程中保持呼吸道通畅、预防VAP的重要举措之一即为呼吸道湿化，而气道黏膜纤毛黏液正常的重要保障为吸入气体的温度和湿度[4]，故合理的机械通气方式在临床治疗中至关重要。本研究采用前瞻性随机对照方法，比较密闭型双加热丝和普通型无加热丝呼吸机管道湿化模式的效果，并对比两者对VAP发生率的影响，为临床选择合理的呼吸道湿化模式及降低VAP的发生率提供理论依据，现报道如下。……