Supracapsular secretion drainage of tracheal intubation before percutaneous dilational tracheotomy in reducing the incidence of early-onset VAP after surgery
10.3760/cma.j.cn115682-20191126-04300
- VernacularTitle:经皮气管切开术前气管插管囊上分泌物引流降低术后早发型VAP发病率的效果
- Author:
Weizhong WANG
1
;
Yaoying ZHOU
;
Xiaoyan YAO
;
Xuedong SUN
Author Information
1. 绍兴市人民医院重症医学科 312000
- Keywords:
Intensive care unit;
Pneumonia, ventilator-associated;
Tracheotomy;
Tracheal intubation;
Supracapsular secretion
- From:
Chinese Journal of Modern Nursing
2020;26(12):1638-1641
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the relationship between supracapsular secretion drainage of tracheal intubation before percutaneous dilational tracheotomy (PDT) and the incidence of early-onset VAP (within 5 days) after PDT.Methods:By the convenient sampling method, a total of 160 patients who underwent PDT in ICU of Shaoxing People's Hospital from March 2013 to March 2019 were selected as the research objects and they were divided into group A and group B according to the random number table method, 80 cases in each group. In group A, the research team intervened to drain supracapsular secretion before PDT and bedside nurses cooperated with the doctor to complete other operations on the PDT. In group B, the PDT operation was entirely completed by the bedside nurses and the research team did not intervene. The drainage volume of supracapsular secretion in group A was recorded and the proportion of patients who underwent supracapsular secretion drainage in group B was calculated. The incidence of VAP, ICU mechanical ventilation time, ICU hospitalization time and ICU hospitalization cost within 5 d after PDT were compared between the two groups.Results:Before PDT, patients in group A drained (3.88±2.34) ml of supracapsular secretion. The proportion of bedside nurses in group B who drained secretions before PDT was 53.75% (43/80) . The incidence of VAP within 5 d after PDT in group A was 6.25% (5/80) , which was lower than 17.50% (14/80) in group B, and the difference was statistically significant ( P<0.05) . The ICU mechanical ventilation time and hospital stay of patients in group A were respectively (28.75±8.59) d and (30.91±9.12) d, which were lower than (32.91±8.53) d and (34.28±9.54) d in group B, and the differences were statistically significant ( P<0.05) . The ICU hospitalization cost of group A was (14.98±4.54) ten thousand yuan, which was lower than (16.93±5.37) ten thousand yuan in group B, and the difference was statistically significant ( P<0.05) . Conclusions:Supracapsular secretion drainage of tracheal intubation before PDT can reduce intraoperative aspiration of supracapsular secretion, reduce the incidence of early-onset VAP after PDT and improve prognosis of patients.
