拋棄式雙端加熱呼吸器管路與呼吸器相關肺炎之研究

The Relation between Disposible Dual Heated-wire Ventilator Circuits and Ventilator-associated Pneumonia

董慧萍(Hui-ping Tung)

指導教授 ： 黃建財

中臺科技大學/管理學院/健康產業管理研究所/碩士(2011年)

https://doi.org/10.6822/CTUST.2011.00066

摘要

中文摘要
本研究主要在探討拋棄式雙端加熱呼吸器管路更換頻率與呼吸器相關肺炎(ventilator-associated pneumonia,VAP)的相關性，以及比較拋棄式雙端加熱呼吸器管路與重覆式消毒呼吸器管路VAP感染率差異，以了解此兩種呼吸器管路VAP發生率是否有顯著差異。
本研究採historical comparison study，以中部某區域醫院內外科加護病房為研究場所，回溯2006年6月至2009年6月病歷，在不常規更換呼吸器管路臨床操作下，依照呼吸器管路更換頻率的不同分為三組。第一組為7天以內更換，第二組為8-14天更換，第三組為15-21天更換。比較三組VAP發生率差異是否具有統計意義。將此三組使用拋棄式雙端加熱呼吸器管路族群視為研究組，另以北部同等級區域醫院以重覆式消毒管路為對照組，比較兩組發生的感染密度。研究工具包括基本資料表、VAP病患收案單。
結果顯示三組中以呼吸器使用天數及ICU住院天數此兩自變數影響VAP感染率(p<0.05)。檢定更換頻率不同的三組，三組感染率未有顯著差異。將三組感染率分別與對照組算出勝算比，第一組(7日內換)與對照組(重覆式管路)odds ratio為0.148(0.077-0.283)；第二組(8-14日更換)與對照組(重覆式管路)odds ratio為0.308 (0.110-0.857)；第三組(15-21日更換)與對照組(重覆式管路)odds ratio為0.279(0.093-0.834)。再將此三組個案合併為一研究組(拋棄式管路組)與對照組(重覆式消毒管路組)的感染率及感染密度均具統計意義(p<0.05)。
本研究認為使用拋棄式雙端加熱呼吸管路時更換頻率不同不會影響VAP感染率，使用拋棄式雙端加熱管路較重覆式消毒管路VAP感染率較低，建議臨床上使用拋棄式雙端加熱呼吸器管路以降低VAP感染率。

關鍵字：拋棄式雙端加熱呼吸器管路、呼吸器相關肺炎、呼吸器管路更換頻率、感染率、感染密度

關鍵字

感染密度 ； 拋棄式雙端加熱呼吸器管路 ； 呼吸器相關肺炎 ； 感染率 ； 呼吸器管路更換頻率

並列摘要

Abstract
This study focuses on the disposable dual heated-wire ventilator circuit change frequency and ventilator-associated pneumonia (ventilator-associated pneumonia, VAP) relevance, And to compare theVAP infection rate between disposable double heated-wire ventilator circuit and reusable ventilator circuit in order to understand whether there are significant differences in incidence.
Mining historical comparison study,A regional hospital in medical and surgical intensive care unit from June 2006 to June 2009 reviewed the medical records, followed clinical operation not routinely change the ventilator circuit , according to the frequency of ventilator circuit change were divided three groups. The first group replacement is 7 days, 8-14 days to replace the second group, third group, the 15-21 days to replace. Comparison of the infection rate of VAP between the three groups if significant or not.Compared VAP infection rate between disposable double heated-wire as study group and the other hospital which using reusable circuit as a control group,Research tools include basic information table,VAP patients enrolled in a single.
The results showed that in ventilator days and ICU length of stay of are statistically significantly affect the VAP infection rate (p <0.05).No significant difference in infection rates of three groups. The three groups with the control group were calculated prevalence odds ratio, the first group (for 7 days) vs control group (conventioal circuit) OR 0.148 (0.077-0.283); the second group (8-14 replacement) and the control group (conventioal circuit) OR 0.308 (0.110-0.857); the third group (15-21 replacement) and the control group OR 0.279 (0.093-0.834).Then three groups were combined into one study group (disposable group) and control group (reusable group) prevalence odds ratios were calculated with a statistical significance (p<0.05)。
This study suggests that disposable dual heated-wire ventilator circuit change frequence will not affect the the infection rate of VAP, the disposable dual heated-wire less than reusable circuit infection rate of VAP.Proposed clinical use disposable dual heated-wire ventilator circuit reduce the VAP infection rate .

Keywords: disposable dual heated-wire ventilator circuit, ventilator-associated pneumonia,
ventilator circuit change frequence,
VAP infection rate,VAP density

並列關鍵字

disposable dual heated-wire ventilator circuit ； ventilator-associated pneumonia

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