姚欢,张静萍,乔国瑾,刘明,周谊霞
YAO Huan,ZHANG Jingping,QIAO Guojin,LIU Ming,ZHOU Yixia

• 1:贵州医科大学研究生院
• 2:贵州医科大学附院
• 3:贵州医科大学护理学院

摘要(Abstract)：

目的:观察根据痰液黏稠度设定气道湿化温度对气管切开机械通气患者的影响。方法:将60例机械通气患者随机分为对照组和试验组,对照组由护士根据经验设定呼吸机吸入端温度,试验组根据患者痰液黏稠度评分表设定呼吸机吸入端温度,观察两组患者试验当天(第1天)、第2天、第3天、第4天痰液中α-酸性糖蛋白(AAG)、Ca2+含量、p H值,并比较两组24 h湿化罐内灭菌注射用水消耗量、24 h痰液总量及气道相关并发症发生率。结果:从第2天起,试验组AAG含量逐渐减少,对照组AAG含量逐渐增加,两组比较差异有统计学意义(P<0.05);试验组Ca2+含量逐渐减少,对照组Ca2+含量逐渐增加,两组比较差异有统计学意义(P<0.05);试验组p H逐渐升高,对照组p H逐渐降低,两组比较差异有统计学意义(P<0.05)。从第2天起,同一时段试验组24 h痰液总量及灭菌注射用水量较对照组多,差异有统计学意义(P<0.05)。试验组发生呼吸机相关性肺炎(VAP)、气道黏膜出血及痰液堵塞等气道相关并发症较对照组少,两组比较差异有统计学意义(P<0.05)。结论:根据患者痰液黏稠度设定呼吸机气道湿化温度,更利于提高呼吸道的治疗效果,降低气道相关并发症,提高气道护理质量。
Objective: To observe the effect of setting airway humidification temperature according to sputum viscosity on patients with tracheostomy and mechanical ventilation. Methods: Sixty patients with tracheostomy and mechanical ventilation were randomly divided into control group and an experimental group. The airway humidification temperature of inhalation end of breathing machine in control group was set according to nurse's experiences while in experimental group it was set according to the self-made sputum viscosity score. The α-acid glycoprotein( AAG),Ca2 +content,PH value of sputum were measured in two groups on 1th,2th,3th,4thday of experiment. Meanwhile,24 h consumption of sterile water for injection in humidification tank,24 h total sputum volume and airway complications were compared between two groups. Results: From the second day of experiment,AAG content in experimental group decreased gradually while AAG content in control group increased gradually,and the differences were statistically significant( P < 0. 05). Ca2 +content in experimental group decreased gradually while increased gradually in control group,and the differences were statistically significant(P < 0. 05). p H value of sputum in experimental group increased while decreased in control group,and the differences were statistically significant( P < 0. 05). From the second day of experiment,24 h total sputum volume and 24 h consumption of sterile water for injection in humidification tank in experimental group were significantly more than their counterparts in control group at the same experimental period of time( P < 0. 05). In experimental group,the incidence rate of airway complications such as VAP,airway mucosal bleeding and sputum blockage were less than their counterparts in control group,and the differences were statistically significant( P < 0. 05). Conclusion: Choosing appropriate airway humidification temperature of breathing machine according to sputum viscosity is more conducive to improve the treatment effect of the respiratory disease,reduce airway complications and improve airway nursing quality.

关键词(KeyWords)： 机械通气;气道湿化;温度;痰;糖蛋白类
mechanical ventilation;airway humidification;temperature;sputum;glycoprotein

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 姚欢,张静萍,乔国瑾,刘明,周谊霞
YAO Huan,ZHANG Jingping,QIAO Guojin,LIU Ming,ZHOU Yixia

DOI: 10.19367/j.cnki.1000-2707.2016.02.035

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