【摘要】：目的:探討在無創(chuàng)機械通氣患者是否有使用呼吸過濾器(breathing filter,BF)的必要性,為臨床的合理應用提供參考依據。方法:(1)選取進行無創(chuàng)機械通氣的30例患者,在呼吸過濾器分別使用24h、48h后,對過濾膜的兩側分別采樣并進行細菌檢測以評價濾菌效果;(2)根據濾菌效果研究結果,將進行無創(chuàng)機械通氣的450例患者隨機分為三組:A組(使用呼吸過濾器且每24h更換)、B組(未使用呼吸過濾器)、C組(使用呼吸過濾器且每48h更換),比較三組患者ICU住院時間、無創(chuàng)機械通氣時間、醫(yī)院獲得性肺炎(hospital acquired pneumonia,HAP)感染率、疾病轉歸等指標。結果:(1)呼吸過濾器使用24h后濾菌率為100%,使用48h后濾菌率為92.85%;(2)對比使用24h、48h后的呼吸過濾器過濾膜兩側即呼吸機側與患者側的細菌檢測結果差異無統(tǒng)計學意義(P0.05);(3)三組患者在ICU住院時間、無創(chuàng)機械通氣時間、HAP感染率以及疾病轉歸差異無統(tǒng)計學意義(P值分別為0.1134、0.5988、0.8580、0.0796)。結論:(1)呼吸過濾器在無創(chuàng)機械通氣中使用48h后亦具有良好的細菌濾過功能;(2)在無創(chuàng)機械通氣患者中未使用呼吸過濾器,其ICU住院時間、無創(chuàng)機械通氣時間、HAP感染率并未增加,患者預后也未受,卻增加了患者的經濟成本,建議在無創(chuàng)機械通氣中可以不使用呼吸過濾器。
[Abstract]:Objective: to explore the necessity of using breathing filter (breathing filter,BF) in patients with non-invasive mechanical ventilation. Methods: (1) A total of 30 patients undergoing non-invasive mechanical ventilation were selected. After 24 h or 48 hours of use of the filter respectively, the two sides of the membrane were sampled and the bacteria were detected to evaluate the effect of the filter. (2) according to the results of the study, 450 patients undergoing non-invasive mechanical ventilation were randomly divided into three groups: group A (using breathing filter and changing every 24 hours) and group B (without breathing filter) and group C (using breathing filter and changing every 48 hours). The hospitalization time of ICU was compared among the three groups. Non-invasive mechanical ventilation time, hospital acquired pneumonia (hospital acquired pneumonia,HAP) infection rate, disease outcome and other indicators. Results: (1) the bacteriological rate of respiratory filter was 100 after 24 h and 92.85 after 48h; (2) there was no significant difference between the two sides of the filter membrane after 24 h and the patient side (P0.05); (3). Length of stay in ICU, There was no significant difference in HAP infection rate and disease outcome (P = 0.11340.5988U 0.8580,0.0796). Conclusion: (1) the respiratory filter also had good bacterial filtration function after 48 hours of non-invasive mechanical ventilation, (2) the ICU hospitalization time and the time of non-invasive mechanical ventilation did not increase in the patients with non-invasive mechanical ventilation. The patient's prognosis is not affected, but increases the patient's economic cost, the recommendation may not use the breath filter in the noninvasive mechanical ventilation.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R472

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