关键词: 气管切开术, 痰, 环境污染物, 呼吸防护装置, 设备设计, 结果评价(卫生保健)

Abstract:

Objective: To analyze the effect and safety of a device for preventing sputum splashing in reducing sputum splash contamination patients undergoing tracheotomy. Methods: Fifty-four patients who were prepared to undergo tracheotomy in the Intensive Care Unit of the General Surgery Department of the Ninth People’s Hospital affiliated to Shanghai Jiaotong University School of Medicine from April to December 2023 were selected as research objects. A convenient sampling method was used to include those with odd-numbered of medical records were included in observation group (wearing the new sputum splash prevention device) and those with even-numbered medical records were included in the control group (wearing the self-made simple plastic bottle sputum splash prevention device), 27 cases in each group. The sputum splash, blood oxygen saturation, partial pressure of carbon dioxide, and incidence of pulmonary infection were compared between the two groups before and after wearing the device. Results: In the observation group, no patient splashed sputum into the surrounding environment after using the new device, and no patient had pulmonary infection after 1 month of using the device, while in the control group, sputum flowed along the wall of the cup, and 4 patients (14.8%) had lung infection after 1 month of using the device. The mean oxygen saturation before and after using the device in the control group were (96.42±4.93) % and (97.01±3.40) %, and the partial pressures of carbon dioxide were (39.88±7.64) mmHg and (38.13±8.09) mmHg, while in the observation group before and after the use of the new device, the mean oxygen saturation were (97.43±3.73) % and (98.33±1.40) %, and the partial pressures of carbon dioxide were (38.14±9.05) mmHg and (42.05±7.89) mmHg. None of the differences were statistically significant (t=-1.329,P=0.197;t=0.476,P=0.638;t=1.965,P=0.060;t=-1.284,P=0.212). Conclusion: The new device for preventing sputum splash is simple to operate, and the avoidance of sputum splash after wearing is better than the self-made simple plastic bottle device, which effectively prevents lung infection and does not affect the patient’s oxygen saturation and carbon dioxide partial pressure. The new device for preventing sputum splash can be used for patients who are taken off the machine after tracheotomy in the intensive care unit, and it can be widely used in clinical practice.

Key words: Tracheotomy, Sputum, Environmental pollutants, Respiratory protective devices, Equipment design, Outcome assessment (health care)