目的：对比分析不同浓度碳酸氢钠溶液用于重度吸入性损伤呼吸机辅助患者气道护理的效果。方法选取2012年5月～2014年5月收治的重度吸入性损伤并行呼吸机辅助呼吸的患者80例作为研究对象，随机分为对照组和观察组，每组各40例患者。对照组使用常规浓度的碳酸氢钠溶液（1．25％）清洗气道，观察组使用高浓度的碳酸氢钠溶液（5％）清洗气道。两组患者治疗和护理方案相同，对比治疗后两组患者的主观感觉气道舒适度、痰液稀释度及性状、痰液培养真菌阳性率、肺部感染情况。结果从第6天开始，观察组患者的气道舒适度明显改善，对照组患者气道舒适度增加幅度缓慢，两组之间具有显著性差异（ P＜0．05）。从第9天开始，观察组痰液粘稠度显著低于对照组，组间差异显著（ P＜0．05）。5％碳酸氢钠溶液可有效预防真菌感染，对照组中1．25％的碳酸氢钠预防真菌感染的能力较弱（ P＜0．05）。伤后第15天，对照组肺部感染率为37．5％，观察组的肺部感染率为27．5％，χ2＝10．321，P＜0．05，两组肺部感染率具有显著差异。结论对于重度吸入性损伤患者，5％碳酸氢钠溶液比常规的1．25％碳酸氢钠溶液对气道的护理效果更好。%Objective To investigate the effect of NaHCO3 in two different concentrations on airway care sever inha-lation injury patients.Methods A total of 80 cases airway care sever inhalation injury were randomly divided into control group ( 1.25% NaHCO3 used for airway irrigation ) and observation group ( 5% NaHCO3 used ) on May 2012 to May 2014.Treatment and care program in both groups were the same.After the treatment, compare the subjective score of airway comfort feeling, sputum viscosity, positive fungal cultures and lung infection rate between the two groups. Results The subjective score of airway comfort feeling in the observation group was significantly higher than that of the control group 6 days after the injure(P<0.05).Sputum viscosity in the observation group was significantly lower than that of the control group 9 days after the injure(P<0.05).5% NaHCO3 was better at preventing the fungal infection than the 1.25%NaHCO3(P<0.05).15 days after the injure, lung infection rate of the observation group was 27.5%, which was much lower than that of the control group(37.5%).The difference was significant (χ2 =10.321,P<0.05). Conclusions 5%NaHCO3 can effectively dilute sputum and facilitate drainage, enhance the degree of patients′airway comfort, and prevent the fungal infection.
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