RESUMO
Objective To investigate the clinical effect of the improved continuous subglottic approach in patients with mechanical ventilation. Methods A total of 90 ICU patients with mechanical ventilation , were divided into observation group and control group 1 and control group 2 by random digits table method,each group was 30 cases.The observation group used the improved continuous subglottic suction. The control group 1 used the way of continuous 24 h suction under glottis. The control group 2 used the way of every 2 h suction under glottis combined with subglottic. The incidence of ventilator-associated pneumonia (VAP), the rate of tube blockage, the amount of subglottic secretion and the damage of airway mucosa were observed. Results The incidence of 7 d VAP in the observation group was 3.33％(1/30), which was not significantly different from that in the control group 1 and the control group 2 (P>0.05), but it was lower than the incidence of VAP at home and abroad. The rate of plugging in the observation group was 6.67％(2/30), and that in the control group 1 was 23.33％(7/30), and the difference was statistically significant (χ2=4.320, P<0.05). The daily flow rate of subglottic secretion was (30.93 ± 8.01) ml/d in the observation group, and (19.75 ± 6.52) ml/d in the control group 2, the difference was statistically significant (t=7.542, P<0.05). The injury rate of airway mucosa in the observation group was 10.00％(3/30), and 33.33％(10/30) in the control group 1, the difference was statistically significant (χ2=4.812, P<0.05). Conclusions The improvement suction under glottis method can be widely applied in clinical practice,which can effectively reduce the incidence of VAP, subglottic tube plugging rate, fully drainage of subglottic secretions, the degree of airway mucosa damage, reduce nursing workload compared with intermittent subglottic.