目的 研究PVC气管切开套管内套管清洗时间与呼吸机相关性肺炎的相关性,比较12 h与24 h清洗内套管前后,内套管内壁细菌培养结果的差异性,为预防呼吸机相关性肺炎提供科学依据.方法 2010年1-12月,在我院综合ICU气管切开行机械通气患者共60例,采用抛硬币法随机分为2组,观察组30例,每12 h对内套管进行清洗及浸泡1次;对照组30例,每24 h对内套管清洗及浸泡1次,两组分别在气管切开行机械通气后第3、第5、第7天在清洗内套管前后对两组患者内套管内壁表面用无菌咽拭子涂擦后,送至检验科进行细菌培养及分类.结果 观察组清洗前、后内套管管壁细菌菌株数均明显少于对照组(P＜0.01),观察组呼吸机相关性肺炎发病率低于对照组(P＜0.05),机械通气时间及住院时间两组比较差异无统计学意义(P＞0.05).结论 相对于每24 h清洗气管切开内套管1次,每12 h清洗1次,可减少内套管管壁细菌菌株数,降低呼吸机相关性肺炎发病率.%Objective To study the relationship between the cleaning of tracheotomy inner canula and ventilator -associated pneumonia and to provide reference for the prevention of ventilator-associated pneumonia. Methods A total of 60 patients undergoing tracheotomy for mechanical ventilation from January to December 2010 were randomly divided into control group (ra=30) and experiment group (ra=30). In experiment group, the cleaning of PVC tracheotomy inner canula was carried out per 12 h while in control group, the cleaning was carried out per 24 h. On the 3rd, 5th and 7th day after tracheotomy, the linings of inner canula in two groups were rubbed with pharynx swab and then bacterial culture and classification were conducted. Results There were significantly less bacteria in the linings of experiment group than those of control group (P<0.01) and there were lower occurrence of ventilator-associated pneumonia in experiment group (P<0.05). Conclusion The cleaning of the lining of inner canula per 12 h is beneficial to lowering the incidence of ventilator-associated pneumonia.
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